摘要
目的：探讨慢性心力衰竭（CHF）患儿血清心型脂肪酸结合蛋白（H-FABP）、可溶性ST2蛋白（sST2）水平变化及临床意义。方法选择39例CHF患儿为研究对象，并以健康体检儿童30例为对照组。采用酶联免疫吸附法（ELISA）检测血清H-FABP及sST2，心脏超声测量左室射血分数（LVEF）及左室短轴收缩率（LVFS）。结果39例CHF患儿中男15例、女24例，年龄2月～14岁，包括心内膜弹力纤维增生症（EFE）27例，扩张型心肌病（DCM）12例。按心功能分级标准分为心功能Ⅱ级10例，Ⅲ级15例，Ⅳ级14例。CHF患儿心衰期及心衰缓解期血清H-FABP、sST2、NT-Pro-BNP与对照组比较，差异有统计学意义（χ2=22.57~69.54，P均＜0.01）。心衰期血清H-FABP、sST2在心功能Ⅱ级、Ⅲ级、Ⅳ级三组间任意两组比较差异有统计学意义（χ2=21.03、20.28，P均＜0.05）。EFE、DCM两组间比较血清H-FABP、sST2水平差异无统计学意义（t=0.289、0.678，P均＜0.05）。经Spearman相关分析显示，CHF患儿心衰期血清H-FABP与NT-Pro-BNP、sST2、心功能级别呈正相关（r=0.402～0.644，P均＜0.05）；sST2与NT-Pro-BNP、心功能级别呈正相关（r=0.501、0.678，P均＞0.05），与LVEF、LVFS呈负相关（r=－0.340、－0.329，P均＜0.05）；结论 H-FABP与sST2均参与了心力衰竭的发生发展过程，H-FABP和sST2可能可作为临床诊断和评估CHF的参考指标。
ObjectiveTo study the changes and clinical significance of serum heart-type fatty acid-binding protein （H-FABP） and soluble ST2 protein （sST2） in children with chronic heart failure （CHF）.MethodsThirty-nine children with CHF and 30 healthy children were recruited. Serum levels of H-FABP and sST2 were determined by ELISA, The left ventricular ejection fraction （LVEF） and fractional shortening of the left ventricle （LVFS） were measured by two-dimensional echocardiog-raphy.ResultsIn 39 children with CHF, 15 males and 24 females, aged 2 months to 14 years, included 27 cases of endocardial ifbroelastosis （EFE） and 12 cases of dilated cardiomyopathy （DCM）. According to the cardiac functional grading standard, the children with CHF were divided into 10 cases with cardiac function II, 15 cases with cardiac function III, and 14 cases with cardiac function IV. The mean levels of H-FABP, sST2 and NT-Pro-BNP in children with CHF at stage of heart failure and heart failure remission were statistically higher than those in the healthy children （allP〈0.01）. The serum H-FABP and sST2 levels had signiifcant differences among groups grouped according to cardiac functional grading standard （allP〈0.05）. The serum H-FABP and sST2 levels had no signiifcant difference between the EFE and DCM groups （allP〉0.05）. The Spearman correlation analysis showed that, in children with CHF at stage of heart failure, the serum H-FABP level was positively correlated with NT-Pro-BNP, sST2 and cardiac function （r=0.402、0.621、0.644,P〈0.05）. Serum sST2 level was positively correlated with NT-Pro-BNP and cardiac function （r = 0.501、0.678,P〈0.05）, and was negatively correlated with LVEF and LVFS （r=-0.340、-0.329, P〈0.05）.ConclusionsH-FABP and sST2 are involved in the development of heart failure. H-FABP and sST2 can be used as reference indices for clinical diagnosis and assessment of CHF.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2015年第9期802-806,共5页
Journal of Clinical Pediatrics
