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目的探讨肺炎并心力衰竭患儿血浆尾加压素Ⅱ(UⅡ)水平与肌钙蛋白(cTnI)、左室射血分数(LVEF)的关系及其临床意义。方法选择肺炎并心衰组、普通肺炎组、健康对照组各30例,放射免疫法检测各组血浆UⅡ含量,并检测cTnI及肌酸激酶心肌同工酶(CK-MB),多普勒超声心动图测定患儿的LVEF反映心功能变化,其中肺炎并心衰组有20例治疗后复测UⅡ、cTnI、CK-MB、LVEF。结果肺炎并心衰组与普通肺炎组及健康对照组比较,血浆UⅡ含量、cTnI及CK-MB显著升高,LVEF显著下降(P<0.05),心衰治疗后血浆UⅡ含量、cTnI及CK-MB下降显著(P<0.05),LVEF显著升高(P<0.05),肺炎并心衰组治疗前血浆UⅡ与cTnI、CK-MB呈显著正相关,与LVEF呈显著负相关,UⅡ与LVEF的线性回归方程为y=-4.43x+83.673。结论 UⅡ参与肺炎并心衰的病理生理过程,血浆尾加压素Ⅱ的含量可反映心功能的程度,通过UⅡ与LVEF的线性回归方程计算出LVEF,血浆UⅡ可作为心力衰竭的定量诊断指标,肺炎并心力衰竭时血浆尾加压素Ⅱ的升高与心肌损害有关。
Objective To investigate the relationship between plasma urotensin Ⅱ (cTnI) and left ventricular ejection fraction (LVEF) and its clinical significance in children with pneumonia and heart failure. Methods Thirty patients with pneumonia complicated with heart failure, common pneumonia group and healthy control group were selected. Radioimmunoassay (RIA) was used to detect the content of plasma UⅡ in each group, and the levels of cTnI, creatine kinase (CK-MB), Doppler ultrasound The LVEF in children with cardiogram showed changes of cardiac function. Among them, 20 cases of pneumonia and heart failure group were retested UⅡ, cTnI, CK-MB and LVEF after treatment. Results The levels of plasma UⅡ, cTnI and CK-MB were significantly increased in patients with pneumonia and heart failure as compared with those in patients with pneumonia and normal controls (P <0.05). The levels of plasma UⅡ, cTnI and CK- MB decreased significantly (P <0.05), while LVEF increased significantly (P <0.05). Plasma UⅡ was positively correlated with cTnI, CK-MB and negatively correlated with LVEF before treatment in patients with pneumonia and heart failure, The linear regression equation is y = -4.43x + 83.673. Conclusions UⅡis involved in the pathophysiological process of pneumonia and heart failure. The content of urotensin Ⅱ can reflect the degree of cardiac function. The LVEF can be calculated by the linear regression equation of U Ⅱ and LVEF, and the plasma UⅡ can be used as a quantitative diagnostic index of heart failure. Pneumonia and heart failure plasma urotensin Ⅱ and myocardial damage related to increased.