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Objective:To explore the application value of plasma brain natriuretic peptide(BNP) level in cardiac function rating of children with left-to-right shunt congenital heart disease.Methods:Sixty children with left-to-right shunt congenital heart disease(30 cases of right heart type and 30 cases of left heart type) admitted to Zhongshan Boai Hospital and Dayong Hospital from April 2017 to August 2019 were selected in this research.Children with right heart type congenital heart disease were selected as study group 1, children with left heart type congenital heart disease were selected as study group 2, and 30 healthy children undergoing routine physical examination at the same time period were selected as control group.Plasma BNP concentration and echocardiogram were measured in all three groups.The plasma BNP level, left ventricular ejection fraction(LVEF), left ventricular end diastolic inner diameter(LVEDD), right ventricular end diastolic inner diameter(RVEDD), pulmonary circulation blood flow/systemic circulation blood flow ratio(Qp/Qs) and left ventricular Tei index were observed and compared among the three groups.Results:The LVEF and RVEDD in the study group 1 were not significantly different from those in the control group(all P>0.05). The LVEDD[(45.40±7.48)mm], Qp/Qs (1.80±0.25), left ventricular Tei index(0.35±0.14), BNP[(64.33±22.18)ng/L] in the study group 1 were significantly higher than those in the control group[(34.33±4.93)mm, (0.95±0.11), (0.28±0.05), (33.66±10.80)ng/L], the differences were statistically significant ( t=6.77, 17.05, 2.56, 6.81, all P<0.05). The LVEF and RVEDD in the study group 2 were not significantly different from those in the control group(all P>0.05). The LVEDD[(45.39±7.52)mm], Qp/Qs (1.78±0.25), left ventricular Tei index(0.35±0.14) and BNP[(64.30±22.21)ng/L] in the study group 2 were significantly higher than those in the control group[(34.33±4.93)mm, (0.95±0.11), (0.28±0.05), (33.66±10.80)ng/L], the differences were statistically significant( t=6.74, 16.64, 2.58, 6.80, all P<0.05). The BNP level in study group 1 was positively correlated with RVEDD, Qp/Qs and left ventricular Tei index( r=0.629, 0.719, 0.651, all P<0.05). The BNP level in the study group 2 was positively correlated with RVEDD, Qp/Qs and left ventricular Tei index( r=0.539, 0.792, 0.748, all P<0.05). There were no correlations between BNP level and LVEF in the study group 1 and study group 2(all P>0.05). After operation, the BNP[(44.05±12.41)ng/L], LVEDD[(43.48±4.45)mm], Qp/Qs(1.03±0.06) and left ventricular Tei index(0.31±0.10) in the study group 1 were lower than those before operation, and the differences were statistically significant ( t=5.23, 2.94, 18.20, 3.34, all P<0.05). After operation, the BNP[(40.96±14.30)ng/L], LVEDD[(22.23±3.65)mm], Qp/Qs(1.05±0.11) and left ventricular Tei index(0.31±0.05) in the study group 2 were lower than those before operation, and the differences were statistically significant( t=3.86, 3.08, 14.73, 4.26, all P<0.05). Conclusion:The application of plasma BNP level detection in left-to-right shunt congenital heart disease has definite effect and certain application value.
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Objective:To explore the clinical value of combined detection of plasma BNP and Tei index in evaluating left ventricular function in children with congenital heart disease before interventional therapy.Methods:From April 2017 to April 2019, a total of 60 children with congenital heart disease who were going to receive interventional therapy in Dachong Hospital of Zhongshan and Boai Hospital of Zhongshan were selected as observation subjects, and the patients were divided into cardiac function class Ⅰ group and cardiac function class Ⅱ group according to NYHA cardiac function classification, with 30 cases in each group.At the same time, 30 normal children were selected as healthy control group.The differences of plasma BNP concentration, left ventricular ejection fraction(LVEF) and left ventricular Tei index in different group were compared.The correlation between the plasma concentration and the cardiac function was investigated, and the correlation between the plasma BNP concentration and the Tei index was analyzed.Results:The concentration of serum BNP[(6.8±1.2)ng/L] and the Tei index of left ventricle (0.63±0.08) in the cardiac function class Ⅱ group were significantly higher than those in the cardiac function class Ⅰ group[(5.4±1.3)ng/L, (0.48±0.11)], and the differences were statistically significant ( t=1.92, 3.01, all P<0.05). These two indicators of the two groups were higher than those of the healthy control group[(3.7±1.5)ng/L, (0.33±0.09)], the differences were statistically significant( t=2.14, 2.28, 4.19, 6.14, all P<0.05). In addition, the LVEF of the cardiac function class Ⅱ group was significantly lower than that of the cardiac function class Ⅰ group( t=5.00, P<0.05), and the LVEF of the two groups were significantly lower those that of the healthy control group( t=10.32, 4.51, all P<0.05). With the increase of severity of cardiac insufficiency, the BNP and Tei index gradually increased( F=3.054, 3.491, all P<0.05), and the LVEF value decreased gradually ( F=12.50, P<0.05). At the same time, the linear correlation analysis showed that the plasma BNP concentration had a positive correlation with the left ventricular Tei index( r=0.69, P<0.01). Conclusion:Plasma BNP combined with Tei index can quickly and accurately assess the left ventricular function in children with congenital heart disease before intervention.As a sensitive index for clinical detection, it has clinical application value.
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Objective To investigate the clinical effect of ibuprofen in treating severe hand foot mouth dis-ease and its effect on serum IL-6,TNF-αand IL-8.Methods 154 cases of severe hand foot and mouth disease were randomly divided into conventional treatment group and ibuprofen treatment group(each group 77 cases).And 77 cases of hand foot and mouth disease in the same period were admitted as normal control group.,.Two treatment group were given conventional antiviral and symptomatic treatment,ibuprofen treatment group was conducted with application of ibuprofen suspension liquid or drops of oral or nasal feeding.The clinical symptoms and signs,blood bi-ochemical indexes,cerebrospinal fluid index and related cytokines were observed in the ibuprofen treated group and the routine treatment group.Results 72 hours after treatment,the treated with ibuprofen group of body temperature (t=10.330,P=0.000),respiration(t=2.460,P=0.016),pulse(t=3.200,P=0.002)and blood pressure(Sys-tolic pressure:t=2.000,P=0.049,Diastolic blood pressure:t=4.890,P=5.42)better than the conventional treat-ment group,cerebrospinal fluid pressure(t=3.330,P=0.001),protein(t=3.370,P=0.001),cell number(t=3.780,P=0.0003)and sugar level(t=3.410,P=0.001)were lower than the conventional treatment group;serum IL-6(t=6.961,P=1.038),IL-8(t=4.229,P=6.463),and TNF-α(t=2.020,P=0.047)were significantly lower than those of the conventional treatment group,the differences had statistical significance(P<0.05).In addi-tion,the treatment group of ibuprofen was superior to the conventional treatment group in the hot withdrawal time(t=5.210,P=1.59)and average hospitalization days(t=3.090,P=0.003).Conclusion Severe hand foot and mouth disease on the basis of routine treatment plus cloth ibuprofen treatment,is ideal effect,and can regulate the serum IL-6,IL-8,and TNF-α.It is worthy of popularization and application.