| Objective: To investigate the significance of serum cystatin C(Cys C)in early renal function evaluation,cardiac function and ventricular remodeling in children with congenital heart disease.Methods: The experimental group consisted of 188 children with CHD aged ≤18 years,including 141 children with complete echocardiographic data,which were divided into the CCHD group and the ACHD group,and 381 children in the control group.(1)The levels of Cys C,SCr,and BUN were compared between the experimental group and the control group,and intra-group comparisons were performed;(2)Correlation analysis was performed between the Cys C levels of each group in the experimental group and various cardiac indexes,and one-way regression analysis was performed to verify them respectively;(3)The PDA-only group,ASD-only group,and VSD-only group were selected from the experimental group,and each group was divided into I and II according to the Cys C(3)Among the experimental groups,the PDA-only group,the ASD-only group and the VSD-only group were selected,and each group was divided into groups I,II,III and IV according to the quadratic method of Cys C level,in which group I had the smallest Cys C value and group IV had the largest Cys C value.Results:(1)The serum Cys C levels in both the CCHD and ACHD groups were significantly higher than those in the control group,the serum Cys C levels in the CCHD group were higher than those in the ACHD group,and the Cys C levels in the ACHD group with more than 2 cardiac malformations were higher than those in the PDA only group,the ASD group and the VSD group,and the differences were statistically significant(P < 0.05);whereas the differences in SCr and BUN levels were not statistically significant.(2)Serum Cys C levels and LVMI in children with CCHD(β=-1.520,P < 0.05),serum Cys C levels and LVEF in children with PDA alone(r =-0.404,β=-0.441,P < 0.05),and Cys C levels and E/A values in children in the group with more than 2 combined malformations(r =-0.678,β=-0.488,P < 0.05)were significantly negatively correlated;Cys C levels in children with other types of CHD were significantly positively correlated with LVEDd(β= 0.598,P < 0.05);the correlation between Cys C levels and each cardiac index in the remaining groups was not significant(P > 0.05).(3)Among the groups grouped by Cys C level quartiles,the IVST of group IV of children with ASD alone was smaller than that of groups I and II,with statistically significant differences(P < 0.05);the LVEF values of group IV of children in the PDA-only group were smaller than those of groups I,II and III,with statistically significant differences(P < 0.05),and the LNMI values of group IV were larger than those of group I,with statistically significant differences(P < 0.05);there was no statistically significant difference between the cardiac indexes of each group of children in the VSD-only group(P > 0.05).Conclusion:(1)Serum Cys C levels were more sensitive than SCr and BUN in the early preoperative stage in children with CHD to reflect the early renal function in children with CHD;and Cys C levels were more significantly elevated in children with CCHD and CHD with complex malformations.(2)In children with CCHD,the ventricular remodeling caused by elevated Cys C levels mainly manifested as a decrease in LVMI,suggesting left ventricular shrinkage;in children with simple PDA,the cardiac changes caused by elevated Cys C levels mainly manifested as a decrease in cardiac systolic function and an increase in LVMI,suggesting left ventricular hypertrophy;in children with ACHD with complex cardiac changes,the cardiac changes caused by elevated Cys C levels In children with ACHD with complex cardiac changes,cardiac changes caused by elevated Cys C levels are mainly manifested as decreased diastolic function. |
