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Objective To explore the relationship between the expression of serum B －type natriuretic peptide(BNP) levels and cardiac function,heart failure(HF) in children with ventricular septal defect of congenital heart disease(CHD).Methods From October 2013 to July 2017,150 children with ventricular septal defect of CHD who were treated in Yuncheng Central Hospital were selected ,and they were divided into no HF group (n＝40),mild HF group(n＝46) and moderately severe HF group ( n＝64) according to the New York university pediatric heart failure index(NYU PHFI) evaluation standard.Meanwhile,148 healthy children were selected as control group.The serum BNP levels,left ventricular ejection fraction (LVEF),left ventricular ejection fraction shortening rate (LVFS), left ventricular end diastolic diameter index (LVEDDI) and cardiac output index (CI) were measured in all subjects. The levels of BNP,LVFS,LVEF,LVEDDI and CI in the study group were compared with those in the control group. The levels of BNP,LVEF,LVFS,LVEDDI and CI in children with CHD ventricular septal defect were compared.The relationship between the level of BNP and LVEF ,LVFS,LVEDDI and CI in patients with ventricular septal defect of CHD was analyzed.Results The serum level of BNP in the study group was (268.47 ±25.48) ng／L,the levels of LVEF,LVFS,LVEDDI and CI in the study group were (55.56 ±4.23)%,(27.96 ±2.74)%,(77.56 ±6.54)mm／m2, (3.35 ±0.41) L· min－1·( m2 )－1 ,respectively.The serum level of BNP in the control group was (33.41 ± 6.21)ng／L,and the levels of LVEF,LVFS,LVEDDI and CI in the control group were (65.43 ±5.12)%,(36.24 ± 3.23)%,(57.32 ±5.31) mm／m2 ,(4.27 ±0.46)L· min－1·(m2 )－1 ,respectively.The serum levels of BNP and LVEDDI in the study group were significantly higher than those in the control group (t＝109.077,29.306,all P＜0.05),while the levels of LVEF,LVFS and CI in the study group were significantly lower than those in the control group(t＝18.152,23.875,18.231,all P＜0.05).With the increased severity of HF ,the levels of BNP and LVEDDI were increased,while the levels of LVEF,LVFS and CI were gradually decreased ( F＝332.232,245.400,all P＜0.05).The level of serum BNP was negatively correlated with LVEF ,LVFS,CI(r＝－0.705,－0.692,－0.718,all P＜0.05),but it was positively correlated with LVEDDI and HF (r＝0.721,0.735,all P＜0.05).Conclusion The level of serum BNP in patients with ventricular septal defect of CHD is correlated with cardiac function indicators ,and serum BNP is positively correlated with HF in children with ventricular septal defect of CHD ,which plays an important role for the diagnosis,treatment and prognosis of HF.
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OBJECTIVE:To evaluate the effects of clinical pharmacists participating in disease management of chronic heart failure(CHF). METHODS:A total of 180 CHF inpatients selected from cardiovascular medicine department of our hospital during Jan. 2013 to Dec. 2014 were divided into control group and pharmacist management group according to random number table,with 90 cases in each group. The control group was given routine treatment. The pharmacist management group additionally received indi-vidualized pharmaceutical care,such as pharmaceutical monitoring,psychological counseling,medication education and 6-month follow-up. The comprehensive self-care ability of the 2 groups were compared on admission and on discharge;re-hospitalization and mortality were compared between 2 groups within 6 months after discharged;the patients’NYHA classification,LVEF,plas-ma level of NT-proBNP and quality of life were compared between 2 groups on admission and 6 months after discharge. RE-SULTS:There was no statistical significance in the cognition of patients to disease,self-care ability,medication compliance score and total comprehensive self-care ability score between 2 groups on admission (P>0.05). Each score and total score of 2 groups were better on discharge than on admission,and the pharmacist management group was better than control group,with statistical significance(P0.05). There was no statistical significance in NYHA classification,LVEF,plasma level of NT-proBNP be-tween 2 groups on admission(P>0.05). 6 months after discharge,the above 3 indexes of pharmacist management group as well as NYHA classification and plasma level of NT-proBNP of control group were improved significantly compared to on admission;NYHA classification,LVEF and plasma level of NT-proBNP of pharmacist management group were better than those of control group at corresponding period,with statistical significance (P0.05). 6 months after discharge,each score and total score of 2 groups were all better than on admission,and the pharmacist management group was better than control group, with statistical significance (P<0.05). CONCLUSIONS:The participation of clinical pharmacists in the disease management of CHF can significantly improve comprehensive self-care ability,decrease re-hospitalization rate,ameliorate cardiac function and en-hance the quality of life.