Application value of plasma brain natriuretic peptide level in cardiac function rating of children with left-to-right shunt congenital heart disease / 中国基层医药

ABSTRACT

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.