临床儿科杂志
臨床兒科雜誌
림상인과잡지
Journal of Clinical Pediatrics
2015年
9期
802-806
,共5页
马岩岩%冯嵩%李冰露%安金斗
馬巖巖%馮嵩%李冰露%安金鬥
마암암%풍숭%리빙로%안금두
慢性心力衰竭%心型脂肪酸结合蛋白%可溶性ST2蛋白%心功能%儿童
慢性心力衰竭%心型脂肪痠結閤蛋白%可溶性ST2蛋白%心功能%兒童
만성심력쇠갈%심형지방산결합단백%가용성ST2단백%심공능%인동
chronic heart failure%heart-type fatty acid-binding protein%soluble ST2 protein%heart function%child
目的：探讨慢性心力衰竭（CHF）患儿血清心型脂肪酸结合蛋白（H-FABP）、可溶性ST2蛋白（sST2）水平变化及临床意义。方法选择39例CHF患儿为研究对象，并以健康体检儿童30例为对照组。采用酶联免疫吸附法（ELISA）检测血清H-FABP及sST2，心脏超声测量左室射血分数（LVEF）及左室短轴收缩率（LVFS）。结果39例CHF患儿中男15例、女24例，年龄2月~14岁，包括心内膜弹力纤维增生症（EFE）27例，扩张型心肌病（DCM）12例。按心功能分级标准分为心功能Ⅱ级10例，Ⅲ级15例，Ⅳ级14例。CHF患儿心衰期及心衰缓解期血清H-FABP、sST2、NT-Pro-BNP与对照组比较，差异有统计学意义（χ2=22.57~69.54，P均<0.01）。心衰期血清H-FABP、sST2在心功能Ⅱ级、Ⅲ级、Ⅳ级三组间任意两组比较差异有统计学意义(χ2=21.03、20.28，P均<0.05)。EFE、DCM两组间比较血清H-FABP、sST2水平差异无统计学意义（t=0.289、0.678，P均>0.05）。经Spearman相关分析显示，CHF患儿心衰期血清H-FABP与NT-Pro-BNP、sST2、心功能级别呈正相关（r=0.402~0.644，P均<0.05）；sST2与NT-Pro-BNP、心功能级别呈正相关（r=0.501、0.678，P均<0.05），与LVEF、LVFS呈负相关（r=－0.340、－0.329，P均<0.05）；结论 H-FABP与sST2均参与了心力衰竭的发生发展过程，H-FABP和sST2可能可作为临床诊断和评估CHF的参考指标。
目的：探討慢性心力衰竭（CHF）患兒血清心型脂肪痠結閤蛋白（H-FABP）、可溶性ST2蛋白（sST2）水平變化及臨床意義。方法選擇39例CHF患兒為研究對象，併以健康體檢兒童30例為對照組。採用酶聯免疫吸附法（ELISA）檢測血清H-FABP及sST2，心髒超聲測量左室射血分數（LVEF）及左室短軸收縮率（LVFS）。結果39例CHF患兒中男15例、女24例，年齡2月~14歲，包括心內膜彈力纖維增生癥（EFE）27例，擴張型心肌病（DCM）12例。按心功能分級標準分為心功能Ⅱ級10例，Ⅲ級15例，Ⅳ級14例。CHF患兒心衰期及心衰緩解期血清H-FABP、sST2、NT-Pro-BNP與對照組比較，差異有統計學意義（χ2=22.57~69.54，P均<0.01）。心衰期血清H-FABP、sST2在心功能Ⅱ級、Ⅲ級、Ⅳ級三組間任意兩組比較差異有統計學意義(χ2=21.03、20.28，P均<0.05)。EFE、DCM兩組間比較血清H-FABP、sST2水平差異無統計學意義（t=0.289、0.678，P均>0.05）。經Spearman相關分析顯示，CHF患兒心衰期血清H-FABP與NT-Pro-BNP、sST2、心功能級彆呈正相關（r=0.402~0.644，P均<0.05）；sST2與NT-Pro-BNP、心功能級彆呈正相關（r=0.501、0.678，P均<0.05），與LVEF、LVFS呈負相關（r=－0.340、－0.329，P均<0.05）；結論 H-FABP與sST2均參與瞭心力衰竭的髮生髮展過程，H-FABP和sST2可能可作為臨床診斷和評估CHF的參攷指標。
목적：탐토만성심력쇠갈（CHF）환인혈청심형지방산결합단백（H-FABP）、가용성ST2단백（sST2）수평변화급림상의의。방법선택39례CHF환인위연구대상，병이건강체검인동30례위대조조。채용매련면역흡부법（ELISA）검측혈청H-FABP급sST2，심장초성측량좌실사혈분수（LVEF）급좌실단축수축솔（LVFS）。결과39례CHF환인중남15례、녀24례，년령2월~14세，포괄심내막탄력섬유증생증（EFE）27례，확장형심기병（DCM）12례。안심공능분급표준분위심공능Ⅱ급10례，Ⅲ급15례，Ⅳ급14례。CHF환인심쇠기급심쇠완해기혈청H-FABP、sST2、NT-Pro-BNP여대조조비교，차이유통계학의의（χ2=22.57~69.54，P균<0.01）。심쇠기혈청H-FABP、sST2재심공능Ⅱ급、Ⅲ급、Ⅳ급삼조간임의량조비교차이유통계학의의(χ2=21.03、20.28，P균<0.05)。EFE、DCM량조간비교혈청H-FABP、sST2수평차이무통계학의의（t=0.289、0.678，P균>0.05）。경Spearman상관분석현시，CHF환인심쇠기혈청H-FABP여NT-Pro-BNP、sST2、심공능급별정정상관（r=0.402~0.644，P균<0.05）；sST2여NT-Pro-BNP、심공능급별정정상관（r=0.501、0.678，P균<0.05），여LVEF、LVFS정부상관（r=－0.340、－0.329，P균<0.05）；결론 H-FABP여sST2균삼여료심력쇠갈적발생발전과정，H-FABP화sST2가능가작위림상진단화평고CHF적삼고지표。
ObjectiveTo study the changes and clinical significance of serum heart-type fatty acid-binding protein (H-FABP) and soluble ST2 protein (sST2) in children with chronic heart failure (CHF).MethodsThirty-nine children with CHF and 30 healthy children were recruited. Serum levels of H-FABP and sST2 were determined by ELISA, The left ventricular ejection fraction (LVEF) and fractional shortening of the left ventricle (LVFS) were measured by two-dimensional echocardiog-raphy.ResultsIn 39 children with CHF, 15 males and 24 females, aged 2 months to 14 years, included 27 cases of endocardial ifbroelastosis (EFE) and 12 cases of dilated cardiomyopathy (DCM). According to the cardiac functional grading standard, the children with CHF were divided into 10 cases with cardiac function II, 15 cases with cardiac function III, and 14 cases with cardiac function IV. The mean levels of H-FABP, sST2 and NT-Pro-BNP in children with CHF at stage of heart failure and heart failure remission were statistically higher than those in the healthy children (allP<0.01). The serum H-FABP and sST2 levels had signiifcant differences among groups grouped according to cardiac functional grading standard (allP<0.05). The serum H-FABP and sST2 levels had no signiifcant difference between the EFE and DCM groups (allP>0.05). The Spearman correlation analysis showed that, in children with CHF at stage of heart failure, the serum H-FABP level was positively correlated with NT-Pro-BNP, sST2 and cardiac function (r=0.402、0.621、0.644,P<0.05). Serum sST2 level was positively correlated with NT-Pro-BNP and cardiac function (r = 0.501、0.678,P<0.05), and was negatively correlated with LVEF and LVFS (r=?0.340、?0.329, P<0.05).ConclusionsH-FABP and sST2 are involved in the development of heart failure. H-FABP and sST2 can be used as reference indices for clinical diagnosis and assessment of CHF.
