| Objective:Ventricular septal defect(Ventricular Septal Defect,VSD)is the most common congenital heart disease in children,easily lead to end-stage congestive heart failure(Congestive heart failure,CHF),if not timely diagnosis and treatment,mortality,disability rate is very high.This study of VSD with heart failure patients plasma brain natriuretic peptide(Brain Natriuretic Peptide,BNP)and its N-terminal precursor(N-terminal pro-B-type natriuretic peptide,NT-pro BNP)and the level of ultrasound image data,by analyzing the relationship between clinical evaluation standard,to evaluate the value of plasma BNP and NT-pro BNP in the evaluation of cardiac function in children with VSD,to explore the establishment of biological criteria for the diagnosis of VSD children complicated with heart failure.Methods:Selection of 2015.03-2016.12 in our outpatient clinic and hospital treatment of ventricular septal defect in children with 80 cases as experimental group.All children were excluded from the central nervous system,endocrine and immune system diseases,liver and kidney function were in normal range.while 15 cases in our hospital outpatient healthy children as the control group.Left ventricular end diastolic volume index(LVEDVI),left ventricular end systolic wall stress(LVESWS),left ventricular fractional fraction(LVFS)and left ventricular ejection fraction(LVEF)were measured in each group,according to the results of echocardiography,experimental group were divided into 48 cases of heart failure group and 32 cases of heart failure group;BNP and NT-pro BNP concentrations in plasma were measured by ELISA method.And selectthe standard of diagnosis of common heart failure in children(such as the improved Ross standard,NYU PHFI standard),scoring and grading 80 children with VSD.Results: 1.The LVEDVI and LVESWS levels in children with heart failure were higher than those in the control group(P<0.05);LVEF,LVSF levels were lower than those in the control group(P<0.05);The levels of BNP and NT-pro BNP in children with heart failure were significantly higher than those in the non heart failure group(P<0.05),There was no significant difference between the group without heart failure and the normal control group(all P> 0.05).2.The plasma BNP level was positively correlated with NT-pro BNP in children with VSD(r=0.933,P<0.05).3.The plasma BNP level in children with VSD was positively correlated with LVESWS(r=0.883,P<0.05),LVEDVI(r=0.868,P<0.05),and LVEF(r=-0.751,P<0.05),LVFS(r=-0.527,P<0.05)was negatively correlated.Plasma NT-pro BNP level was positively correlated with LVESWS(r=0.889,P<0.05),LVEDVI(r=0.856,P<0.05),and negatively correlated with LVEF(r=-0.676,P<0.05),LVFS(r=-0.494,P<0.05).4.The area of ROC curve of BNP diagnosis of VSD with heart failure was 0.876,more than 337pg/ml in diagnosis of heart failure and the sensitivity was 72.9%,specificity was 93.7%,95% confidence interval ROC curve 0.802-0.951.plasma NT-pro BNP in diagnosis of VSD with heart failure and product 0.924,more than 493fmol/ml in diagnosis of heart failure and the sensitivity was 77.1%,specificity was 100%,95% confidence interval 0.861-0.988.5.ROC curve area of modified Ross standard for evaluation of diagnosis of VSD with heart failure was 0.862,and when the score more than 5 points,the diagnostic sensitivity was 75%,specificity was 96.9%,the accuracy rate was 75%,the misdiagnosis rate was 10%,the misdiagnosis rate was 15%,95% confidence interval 0.779-0.945.The ROC NYU PHFI curve under the standard for evaluation of diagnosisof VSD with heart failure when the product is up to 0.870,7 points more than the diagnosis score,the sensitivity was 87.5%,specificity was 68.7%,the accuracy rate was 80%,the misdiagnosis rate was 7.5%,the misdiagnosis rate was 12.5%,95% confidence interval 0.795-0.946.Conclusion : 1.BNP and NT-pro BNP can be used as VSD with heart failure assessment of heart function in children with simple,sensitive and effective biological index.2.NT-pro BNP diagnosis room deficiency combined with heart failure value than BNP. |
PDF Full Text Request