重型β型地中海贫血患儿BNP和铁超负荷与早期心功能不全的关系研究

doi:10.3969/j.issn.1671-7171.2017.01.013

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Abstract 【Objective】To investigate the relationship among BNP, iron overload and early cardiac dysfunction in severe β-thalassemia children. 【Methods】A total of 42 patients with severe β thalassemia (observation group) from January 2014 to January 2016 in our hospital were enrolled in this study. In the same period time, 40 healthy children were collected as control group. All cases were checked by echocardiography for cardiac parameters and their blood specimen were measured for hemoglobin, BNP, ferritin and other indicators. According to whether there was presence of diastolic dysfunction or not, the observation group were further divided into two subgroups, E / E '<9 and E / E'≥9 groups, based on the ratio of E / E ' (early diastolic mitral flow velocity / septal early diastolic velocity) . In between the two subgroups, patients' cardiac parameters and blood biochemical indices were compared as well. 【Results】BNP and ferritin levels in the observation group were significantly higher than those in the control group while hemoglobin was lower; the differences were statistically significant (P<0.01). LVED (left ventricular end diastolic diameter), LVES (left ventricular end systolic diameter), LA (left atrial diameter), RV (right ventricular diameter), LAVI (left atrial volume index) and LVMI (left ventricular mass index) in the observation group were significantly higher than those in the control group, the differences were statistically significant (P<0.05). E (early diastolic mitral flow velocity), A (late diastolic mitral flow velocity) and E / E ' (septal early diastolic velocity) in the observation group were higher than those in the control group, while IVRT (isovolumic relaxation time), S' (septal systolic velocity) and E' (septal early diastolic velocity) were lower than those in the control group; the differences were statistically significant (P<0.05). In the E / E' ≥9 subgroup, E, E / E ', LVES, LVED, LA, LAVI and LVMI were higher than those in the E / E' <9 subgroup (P<0.05), however, its E 'is lower than in the E/E' <9 subgroup (P<0.05). BNP and ferritin levels were positively correlated in the observation group (r=0.939,P=0.000); levels of BNP and hemoglobin showed no significant correlation (r=0.102,P=0.436). In the observation group, BNP was negatively correlated with S' and A' (septal late diastole) (r=-0.300,-0.421,P=0.043,0.031). BNP showed no correlation with E/E'(r=0.082,P=0.519). In the E / E '<9 subgroup, BNP and ferritin levels were positively correlated (r=0.835,P=0.000) and BNP and E / A ratio was positively correlated (r=0.438,P=0.029). In E / E' ≥9 group, BNP levels and ferritin was positively related (r=0.949,P=0.000) and BNP was positively correlated with LAVI (r=0.396,P=0.026). Further BNP showed negative correlation with S' and A' (r=-0.401,-0.409,P=0.035,0.036). 【Conclusion】BNP levels and diastolic dysfunction showed no significant correlation in severe β-thalassemia children. However, BNP had significant correlation with iron overload, which to some extent reflects cardiac dysfunction.

Key words： beta-Thalassemia Natriuretic Peptide, Brain Iron Overload Heart Failure

Received: 26 August 2016

PACS:

R725.56

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2017.01.013 OR http://www.jcr.net.cn/EN/Y2017/V34/I1/39

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