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目的:探讨血浆尾加压素Ⅱ(UⅡ)在小儿肺炎并心力衰竭时的变化及其临床意义。方法:选择肺炎并心衰组、普通肺炎组、健康对照组各30例,采用放射免疫法检测各组血浆UⅡ含量,并检测心肌肌钙蛋白I(cTnI)及肌酸激酶心肌同工酶(CK-MB)。其中肺炎并心衰组有20例治疗后复测UⅡ、cTnI及CK-MB,多普勒超声心动图测定患儿的左室射血分数(EF)、左室短轴缩短百分率(FS)反映心功能变化的指标。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,EF、FS均显著下降(P<0.05),心衰治疗后血浆UⅡ含量、cTnI及CK-MB下降显著(P<0.05),肺炎并心衰组治疗前血浆UⅡ与EF、FS呈显著负相关,与cTnI、CK-MB呈显著正相关。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,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 changes and clinical significance of plasma urotensin Ⅱ (UⅡ) in children with pneumonia and heart failure. Methods: Thirty patients with pneumonia complicated with heart failure, common pneumonia group and healthy control group were randomly divided into three groups. Radioimmunoassay was used to detect the level of plasma UⅡ in each group and the levels of cardiac troponin I (cTnI) and creatine kinase Myocardial isoenzyme CK-MB). Among the 20 patients with pneumonia complicated with heart failure, UⅡ, cTnI and CK-MB were measured before and after treatment. The left ventricular ejection fraction (EF) and left ventricular fractional shortening (FS) were measured by Doppler echocardiography Index of cardiac function changes. Results: Plasma UⅡcontent, cTnI and CK-MB were significantly increased, and EF and FS were significantly decreased in patients with pneumonia complicated with pneumonia and normal control group (P <0.05). The levels of plasma UⅡ, cTnI and CK-MB decreased significantly (P <0.05). There was a significant negative correlation between plasma UⅡ and EF and FS before treatment in patients with pneumonia and heart failure, and positively correlated with cTnI and CK-MB. CONCLUSION: UII is involved in the pathophysiological process of pneumonia and heart failure. The content of urotensin II may reflect the degree of cardiac function. The increase of urotensin II in patients with pneumonia and heart failure is related to myocardial damage.