摘要
目的探讨支气管肺炎合并心力衰竭(简称心衰)的发病机理。方法对15例肺炎合并心力衰竭患儿和17例肺炎患儿及17例正常健康小儿应用超声心动图检查测定左室收缩末室壁应力、射血分数(EF)、缩短分数(FS)和心率矫正之左室周径平均缩短速度(mVcfc);测定血管紧张素Ⅱ(AⅡ)和红细胞内游离钙水平。结果左室收缩末室壁应力:支气管肺炎合并心衰组(49±6g/cm2)较肺炎组(42±9g/cm2)和正常对照组(41±8g/cm2)增加;AⅡ:支气管肺炎合并心衰组(366±160ng/L)较肺炎组(56±16ng/L)和正常组(38±8ng/L)增高;红细胞内游离钙水平:支气管肺炎合并心衰组F335/F385(1.90±0.28)和肺炎组F335/F385(1.86±0.26)较正常组F335/F385(1.66±0.24)增加;EF、FS和mVcfc无改变。结论支气管肺炎合并心衰无心肌收缩力下降,而AⅡ增加、心脏后负荷增加。它们在支气管肺炎合并心衰的发病中起到重要作用。
Objective To understand the mechanism of congestive heart failure associated with bronchopneumonia. Methods End systolic wall stress, ejection fraction(EF), fractional shortening (FS) and heart rate corrected mean velocity of circumferential fiber shortening (mVcfc) were measured in 15 cases of congestive heart failure associated with bronchopneumonia, 17 cases of pneumonia and 17 controls by using echocardiography. The levels of plasma angiotensin Ⅱ and intra erythrocyte free calcium were also detected. Results End systolic wall stress was elevated with an increment in levels of plasma angiotensin Ⅱ and intra erythrocyte free calcium in cases of congestive heart failure associated with bronchopneumonia as compared with either cases of bronchopneumonia or normal controls (end systolic wall stress: 49±6 g/cm 2 in cases of congestive heart failure associated with bronchopneumonia: 42±9 g/cm 2 in cases of pneumonia and 41±8 g/cm 2 in controls; plasma A Ⅱ level: 366±160 ng/L in cases of congestive heart failure associated with bronchopneumonia, 56±16 ng/L in cases of pneumonia and 38±8 ng/L in controls; intra erythrocyte free calcium level F 335 /F 385 : 1.90±0.28 in cases of congestive heart failure associated with bronchopneumonia F 335 /F 385 : 1.86±0.26 in cases of bronchopneumonia and F 335 /F 385 1.66±0.24 in controls, but there were no changes in EF, FS and mVcfc in these cases. Conclusion Congestive heart failure secondary to bronchopneumonia is not associated with a decrease in cardiac contractility, but an increase in plasma level of angiotensin Ⅱas well as an increase in cardiac after load, play an important role in its pathogenesis.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
1998年第3期175-177,共3页
Chinese Journal of Pediatrics
关键词
支气管肺炎
心力衰竭
病理学
并发症
儿童
Bronchopneumonia Heart failure, congestivee Angiotensin Ⅱ Calcium