| Objective: Congestive heart failure(CHF)is a familiardisease in children ,especially in infants.Severe pneumonia is acause of CHF in infants .Cardiac troponin (CTn)is a specific andsensitive marker of CHF in patients with myocardialinjury .CTnI is more specific than cTnT.There is an increase ofcTnI in adult haman with CHF,and this increase is highlyindicative of reduced left ventricular performance.But theralationship of CHF in infants and cTnI have not beenknown.There are few studys on cTnI and drgees of CHF ininfants. In addition, Ca2+ play a key role on the function ofcardiomyocytes.CHF is associated with the thansfer dysfuntionof calcium.Decrease of Calcium concentration incardiomyocytes and reduced contractile function and calciumoverload can induce diastolic and contractile dysfunction.Inrecent years,the study on change of calcium concentration incardiomyocytes always test in animals. In human do this workonly can do by biopsy.But patients can,t accept.There was astudy indicated the positive relation on intraerythrocytic calciumand myocardial cell.So we study the intracellular Ca2+inmyocardium by testing the intraerythrocytic Ca2+concentrationand evaluate the relation on Ca2+and heart funtion in patientswith severe CHF.CHF can classified into two kinds:contractiledysfunction and diastolic dysfunction.We evaluate the leftventricular contractile function by color Dopplerultrasoundraphy with EF,FS and EV/AV.In a word,the objectiveof this study is to evaluate the relationship amongintraerythrocytic calcium,serum cTnI and contractile anddiastolic dysfunction in patients with infants pneumoniacomplicated CHF and discuss the role on Ca2+and cTnI onpneumonia complicated CHF. Mothods:We selccted 75 patients,and divided them intofour experiment groups:pneumonia(38),pneumonia with mildCHF(38),pneumonia with moderate CHF(36) and pneumoniawith severe CHF(21)(include 30 patients with congenital heartdisease).We selected 65 boys and 68 girls,aged 4.8 ±3.1months.They all except rickets,myocarditis,kidney disease,sepsis and muscule disease.Before exsanguinate,they not usedcalcium and cardial tonic.All the patients measuredintraerythrocytic calcium,serum cTnI and EF ,FS andEV/AV.The datas analysis by SAS 6.12 software and shown bymeans ±standard(x±s).The analysis results of five groups useone-way ANOVA,if there was a diffrence in these groups,thenused SNK-q to compare the difference .The relative analysis isadopted to relative beeline analysis,with statistic meaning beingP<0.05.Results:(1)Intraerythrocytic calcium value is 12.06±2.26umol/l,12.90 ±1.16umol/l,21.00 ±3.30umol/l, 23.56 ±3.90umol/l, 41.63 ±5.55umol/l in gronp of contorl ,pneumonia,pneumonia with mild CHF,moderate CHF andsevere CHF respectively.The statistic analysis show thedifference between mild CHF and control ,pneumonia(P<0.05).(2)Serum cTnI value of control ,pneumonia,mildCHF,moderate CHF and severe CHF is 0.13±0.07ng/ml,0.15±0.08ng/ml,0.64±0.39ng/ml,0.65±1.35ng/ml,1.96±1.68ng/ml,respectiuely.The values is increased gradually .Thestatistic analysis indicate the difference between severe CHFgroup and other groups(P<0.01).(3)The value of EF is decreasedfollowed by the disease aggravation .They are 68.64±5.64%,64.55±5.37%,70.55±5.39%,64.73±3.47%,53.09±3.65%in five groups respectively.The statistic analysis show that thestatistic significant between moderate CHF group and mild CHFgroup(P<0.05) ,severe CHF group and moderate CHFgroup(P<0.01).The change of FS values is consistent with EFvalues. FS is significant reduced in severe CHFgroup(P<0.01),EV/AV values are control group 1.27±0.26 ,pneumonia group 1.27±0.26,mild CHF group 1.24±0.22,moderate CHF group 1.15±0.21,severe CHF group 0.70±0.08.This is a clear difference between severe CHF and othergroups (P<0.01).(4)The levels of Intraerythrocytic calcium,cTnI and EF present remarkably negative relation (r=-0.73 and-0.75, P<0.05).Between cTnI and intraerythrocytic calcium...
|
PDF Full Text Request