ABSTRACT
Objective: To explore the change in the cerebral natriuretic peptide (BNP) levels in the premature infants with hemodynamically significant patent dectus arteriosus (hsPDA) and its relationship with hemodynamics, and to further clarify the clinical significance of BNP in the judgement of illness condition and treatment in the premature infants with hsPDA. Methods: A total of 106 cases of premature infants within 6 h of birth whose gestational age was no more than 32 weeks were selected and divided into hsPDA group (43 cases) and PDA with no hemodynamic significance group (nhsPDA group, 27 cases) and no PDA group (nPDA group, 36 cases). The patients in HsPDA group were divided into hsPDA treatment group (33 cases) and hsPDA non-treatment group (10 cases) according to whether ibuprofen was administrated or not. Echocardiography was performed in the patients in hsPDA treatment group, 7 d after oral ibuprofen administration,and the patients in hsPDA treatment group were divided into hsPDA close group (15 cases) and hsPDA non-close group (18 cases). The left atrium (LA)/aortic root diameter (VO) value, diameter of patent arterial duct, left ventricular ejection fraction (LVEF), shortening fraction, left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were recorded at 1, 3, 7 d after birth of the premature infants in various groups with echocardiography. The level of BNP in plasma was determined by electrochemiluminescence. The correlation analysis was performed between the hemodynamic indexes of echocardiography and the level of BNP in plasma. Results: Compared with nhsPDA group, the LA/VO value, arterial catheter diameter and LVEDD were significantly increased (P<0. 05). The plasma BNP levels of premature infants in hsPDA close and non-close groups at 1 and 3 d after birth were significantly higher than those in nPDA group (P'<0.05); the plasma BNP level of the premature infants in hsPDA close group at 7 d after birth was significantly lower than that at 3 d after birth ( P'<0. 05). Compared with hsPDA non-treatment group, the LA/VO value, arterial catheter diameter, LEVDD and the plasma BNP level of the premature infants in hsPDA treatment group at 7 d after birth were significantly decreased (P<0. 05). The plasma BNP level was positively correlated with the LA/VO value and arterial catheter diameter ( r=0. 727, P<0. 05; r= 0. 780, P<0. 05) of the premature infants in hsPDA group at 3 d after birth. Conclusion: The level of plasma BNP of premature infants 3 d after birth is positively correlated with the hemodynamic indexes, and the detection of the changes of the plasma BNP levels is helpful to judge the condition of preterm infants with hsPDA and to provide basis for its diagnosis.
ABSTRACT
Objective:To explore the change in the cerebral natriuretic peptide (BNP) levels in the premature infants with hemodynamically significant patent dectus arteriosus (hsPDA) and its relationship with hemodynamics, and to further clarify the clinical significance of BNP in the judgement of illness condition and treatment in the premature infants with hsPDA.Methods:A total of 106cases of premature infants within 6hof birth whose gestational age was no more than 32weeks were selected and divided into hsPDA group (43cases) and PDA with no hemodynamic significance group (nhsPDA group, 27cases) and no PDA group (nPDA group, 36cases) .The patients in HsPDA group were divided into hsPDA treatment group (33cases) and hsPDA non-treatment group (10cases) according to whether ibuprofen was administrated or not.Echocardiography was performed in the patients in hsPDA treatment group, 7dafter oral ibuprofen administration, and the patients in hsPDA treatment group were divided into hsPDA close group (15cases) and hsPDA non-close group (18cases) .The left atrium (LA) /aortic root diameter (VO) value, diameter of patent arterial duct, left ventricular ejection fraction (LVEF) , shortening fraction, left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were recorded at 1, 3, 7dafter birth of the premature infants in various groups with echocardiography.The level of BNP in plasma was determined by electrochemiluminescence.The correlation analysis was performed between the hemodynamic indexes of echocardiography and the level of BNP in plasma.Results:Compared with nhsPDA group, the LA/VO value, arterial catheter diameter and LVEDD were significantly increased (P＜0.05) .The plasma BNP levels of premature infants in hsPDA close and non-close groups at 1and 3dafter birth were significantly higher than those in nPDA group (P＜0.05) ;the plasma BNP level of the premature infants in hsPDA close group at 7dafter birth was significantly lower than that at 3dafter birth (P＜0.05) .Compared with hsPDA non-treatment group, the LA/VO value, arterial catheter diameter, LEVDD and the plasma BNP level of the premature infants in hsPDA treatment group at 7dafter birth were significantly decreased (P＜0.05) .The plasma BNP level was positively correlated with the LA/VO value and arterial catheter diameter (r=0.727, P＜0.05;r=0.780, P＜0.05) of the premature infants in hsPDA group at 3dafter birth.Conclusion:The level of plasma BNP of premature infants 3 dafter birth is positively correlated with the hemodynamic indexes, and the detection of the changes of the plasma BNP levels is helpful to judge the condition of preterm infants with hsPDA and to provide basis for its diagnosis.
ABSTRACT
Objective: To investigate the effects of acetaminophen on the hemodynamics, left ventricular function and plasma level of brain natriuretic peptide (BNP) in the premature young rats, and to clarify its mechanism in the treatment of patent ductus arteriosus (PDA) in the premature infants. Methods: The pregnant rats were injected intraperitoneally with lipopolysaccharide (LPS) to prepare the premature young rat models. The premature young rats were divided into model control group (n=18) and administration group (n= 19); another 10 young rats with normal gestratonal age were selected and used as blank control group. The young rats in blank control group didn' t receive any treatment, the young rats in model control group were not given any drug, and the premature young rats in administration group were continunously administrated with acetaminophen for 3 d. Color Doppler ultrasonography was used to detect the hemodynamic parameters of the young rats in various groups, including left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVESd), fractional shortening (FS), left ventricular end-systolic volume (ESV), and left ventricular end-diastolic volume (EDV). The plasma BNP levels of young rats were detected. Results: The body weights of the young rats in administration group and model control group were lower than that in blank control group ( P0.05). Compared with blank control group, the plasma BNP level of the young rats in model control group was significantly increased (P= 0.004); compared with model control group, the plasma BNP level of the young rats in administration group was significantly decreased (P= 0.009). Conclusion: Acetaminophen can protect the left ventricular function of the young rats by improving the hemodynamic indicators and reducing the plasma BNP level.