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 explore the changes of plasma urotensin Ⅱ levels in children with pneumonia combined with heart failure and its clinical significance.Methods:30 children with pneumonia combined with heart failure,30 children with common pneumonia and 30 healthy children were selected,radioimmunoassay was used to detect the plasma urotensin Ⅱ levels in the three groups,the levels of cardiac troponin I(cTnI) and creatinine kinase isoenzyme(CK-MB) were detected;20 children in pneumonia combined with heart failure group received repetition measurement of urotensin Ⅱ,cTnI and CK-MB after treatment;the indicators which reflected the changes of heart function including left ventricular ejection fraction(EF) and fractional shortening of left ventricular short axis(FS) were measured by Doppler ultrasonic cardiogram.Results:Compared with common pneumonia group and control group,the plasma content of urotensin Ⅱ and the levels of cTnI and CK-MB in pneumonia combined with heart failure group increased significantly,EF and FS decreased significantly(P〈0.05);after treatment,the plasma content of urotensin Ⅱ and the levels of cTnI and CK-MB decreased significantly(P〈0.05);before treatment,there was negative correlation between plasma urotensin Ⅱ and EF,FS in pneumonia combined with heart failure group,and there was positive correlation between plasma urotensin Ⅱ and cTnI,CK-MB.Conclusion:Urotensin Ⅱ participates in the pathophysiological process of pneumonia combined with heart failure,the content of plasma urotensin Ⅱ may reflect the degree of cardiac function,the increase of plasma urotensin Ⅱ in patients with pneumonia combined with heart failure is related to myocardial damage.