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目的探讨发绀型先天性心脏病(CHD)患儿血清生长激素释放肽(Ghrelin)及瘦素水平变化的意义。方法选择2007年6月-2009年12月就诊于中国医科大学附属第一、二院CHD患儿42例。其中发绀型CHD患儿(发绀组)17例。男10例,女7例;年龄(37.2±16.5)个月。非发绀型CHD患儿(非发绀组)25例。男13例,女12例;年龄(35.6±19.3)个月。健康对照组20例。男12例,女8例;年龄(33.8±17.7)个月。双抗体夹心ELISA法测定其血清Ghrelin水平,放射免疫法测定其血清瘦素水平。测定各组儿童身高、体质量及体质量指数(BMI)。应用SPSS13.0软件对数据进行统计学分析。结果与健康对照组比较,发绀组及非发绀组Ghrelin水平增高,其中发绀组升高更明显,差异均有统计学意义(Pa<0.01)。发绀组血清瘦素水平低于健康对照组及非发绀组,差异均有统计学意义(Pa<0.01);非发绀组血清瘦素水平与健康对照组比较差异无统计学意义(P>0.05)。发绀组及非发绀组CHD患儿血清Ghrelin水平与BMI均呈负相关(r=-0.66、-0.62,Pa<0.01),血清瘦素水平与BMI均呈正相关(r=0.72、0.75,Pa<0.01)。结论发绀型CHD患儿血清Ghrelin水平增高,瘦素水平降低,可能与此类患儿长期慢性缺氧及全身消耗状态有关。
Objective To investigate the significance of serum ghrelin and leptin levels in children with cyanotic congenital heart disease (CHD). Methods From June 2007 to December 2009, 42 CHD children attending first and second affiliated hospital of China Medical University were selected. Among them, cyanotic CHD children (cyanotic group) in 17 cases. 10 males and 7 females; age (37.2 ± 16.5) months. Non-cyanotic CHD children (non-cyanotic group) 25 cases. There were 13 males and 12 females with a mean age of (35.6 ± 19.3) months. Healthy control group of 20 cases. There were 12 males and 8 females with an average age of (33.8 ± 17.7) months. Serum Ghrelin levels were measured by double antibody sandwich ELISA and serum leptin levels were measured by radioimmunoassay. The height, body mass and body mass index (BMI) of children in each group were determined. The data were analyzed by SPSS13.0 software. Results Compared with healthy control group, the levels of Ghrelin in cyanotic group and non-cyanotic group increased significantly, especially in cyanotic group (P <0.01). The level of serum leptin in cyanotic group was lower than that in healthy control group and non-cyanotic group (P <0.01), while there was no significant difference in serum leptin level between non-cyanotic group and healthy control group (P> 0.05) . Serum levels of Ghrelin in cyanotic and non-cyanotic subjects were negatively correlated with BMI (r = -0.66, -0.62, Pa <0.01), and serum leptin levels were positively correlated with BMI (r = 0.72, 0.75, Pa < 0.01). Conclusions Serum levels of Ghrelin in cyanotic children with CHD are lower and leptin levels are lower, which may be related to long-term chronic hypoxia and systemic consumption status in children with cyanotic CHD.