中国实用儿科杂志

中国实用儿科杂志

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慢性心力衰竭儿童血清PⅠCP、PⅢNP水平的改变及意义

  

  1. 郑州大学第一附属医院儿童医院心内科， 河南  郑州 450052
  • 出版日期:2020-11-06 发布日期:2020-12-10

Changes and significance of serum PⅠCP and PⅢNP levels in children with chronic heart failure

  1. Department of Cardiology，Children’s Hospital，the First Affiliated Hospital of Zhengzhou University，Zhengzhou  450052，China
  • Online:2020-11-06 Published:2020-12-10

摘要： 目的　探讨血清Ⅰ型前胶原羧基末端前肽（the carboxy-terminal propeptide of typeⅠprocollagen， PⅠCP）与Ⅲ型前胶原氨基末端前肽（the amino-terminal propeptide of type Ⅲ procollagen， PⅢNP）在儿童慢性心力衰竭（chronic heart failure， CHF）中的改变及意义。方法　选取2018年2月至2019年6月郑州大学第一附属医院收治的28例CHF患儿作为心衰组， 其中男15例， 女13例， 中位年龄1.00（0.63， 5.50）岁。将心衰组分为心功能Ⅱ级组8例， 心功能Ⅲ级组11例， 心功能Ⅳ级组9例。选取同期体检的17例健康体检儿童作为对照组， 男12例， 女5例， 中位年龄3.88（2.36， 5.38）岁。各组儿童年龄、 性别差异均无统计学意义（P＞0.05）。采用酶联免疫吸附法测定血清PⅠCP、 PⅢNP水平， 心脏超声心动图测量左心室射血分数等相关指标。采用SPSS25.0软件对数据进行统计分析。结果　CHF患儿治疗前血清PⅠCP水平明显高于对照组， 治疗10周后血清PⅢNP水平明显下降， 差异具有统计学意义（P＜0.05）； CHF患儿心功能Ⅳ级组血清PⅠCP、 PⅢNP水平较心功能Ⅱ级组及对照组明显偏高， 差异具有统计学意义（P＜0.05）； 血清PⅠCP、 PⅢNP水平与心功能、 NT-proBNP水平、 左心室舒张末期内径、 左心室质量指数呈正相关， 与左心室射血分数、 左心室短轴缩短率呈负相关。结论　血清PⅠCP、 PⅢNP参与了儿童CHF心肌纤维化的发生发展过程， 且可作为儿童CHF诊断、 心功能分级和疗效评估的新的心脏生物学标志物。

关键词: 慢性心力衰竭, 儿童, Ⅰ型前胶原羧基末端前肽, Ⅲ型前胶原氨基末端前肽

Abstract: To explore the changes and significance of the carboxy- terminal propeptide of typeⅠprocollagen（PⅠCP） and the amino-terminal propeptide of type Ⅲ procollagen（PⅢNP） in children with chronic heart failure（CHF）. Methods　A total of 28 children with CHF admitted between February 2018 and June 2019 to the First Affiliated Hospital of Zhengzhou University were included in the heart failure group，including 15 males and 13 females，with a median age of 1.00（0.63，5.50） years old. Heart failure group was divided as 8 cases in the heart function class Ⅱ group，11 cases in the heart function class Ⅲ group，and 9 cases in the heart function class Ⅳ group. Seventeen healthy children were included as the control group，including 12 males and 5 females，with a median age of 3.88（2.36，5.38） years old. There was no statistical difference in age or gender of children in each group（P＞0.05）. The levels of serum PⅠCP and PⅢNP were measured by enzyme-linked immunosorbent assay. The left ventricular ejection fraction and other related indexes were measured by cardiac echocardiography，and the data was statistically analyzed by SPSS25.0 software. Results　The level of serum PⅠCP and PⅢNP in children with CHF before treatment was significantly higher than that in the control group，and the level of serum PⅢNP was significantly lower after treatment for 10 weeks（P＜0.05）；the level of serum PⅠCP and PⅢNP in children with CHF in grade Ⅳ group was significantly higher than that in grade Ⅱ group and the control group，and the difference was statistically significant（P＜0.05）. The levels of serum PⅠCP and PⅢNP were positively correlated with cardiac function，NT-proBNP level，LVEDd and LVMI，and negatively correlated with LVEF and LVFS. Conclusion　The serum PⅠCP and PⅢNP is involved in the occurrence and development of CHF myocardial fibrosis in children，and can help the clinical diagnosis，grading of cardiac function and treatment effect assessment of children with CHF.

Key words: chronic heart failure, child, the carboxy-terminal propeptide of typeⅠprocollagen, the amino-terminal propeptide of type Ⅲ procollagen