血浆NO、cGMP在小儿左向右分流先天性心脏病中的表达水平及与预后的关系

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Abstract Objective To investigate the expression levels of plasma nitric oxide（NO）and cyclic guanosine phosphate（cGMP）in children with left-to-right shunt congenital heart disease and their relationship with prognosis. Methods A total of 114 children with left-right shunt congenital heart disease in our hospital from January 2018 to May 2021 were retrospectively selected,all of whom received surgical treatment,and were divided into good prognosis group（92 cases）and poor prognosis group（22 cases）according to the prognosis 6 months after surgery. The clinical data,plasma NO and cGMP levels of the two groups were compared,the correlation between plasma NO and cGMP and the disease was analyzed,and the influence and predictive value of plasma NO and cGMP on the prognosis was evaluated. Results The heart function grade,postoperative severity score and the proportion of pulmonary hypertension in the poor prognosis group were higher than those in the good prognosis group. Plasma levels of NO and cGMP in poor prognosis group were lower than those in good prognosis group. The levels of plasma NO and cGMP in grade Ⅳ children were lower than those in grade Ⅲ children than those in grade Ⅱ children;The plasma levels of NO and cGMP in children with higher severity were lower than those in children with lower severity. The plasma levels of NO and cGMP in children with pulmonary hypertension were lower than those in children without pulmonary hypertension. Plasma NO and cGMP levels were negatively correlated with cardiac function grade,postoperative severity and pulmonary hypertension. Low levels of plasma NO and cGMP significantly increased the risk of poor prognosis in children with left-to-right shunt congenital heart disease. The OR values were 2.563 and 1.921,respectively,and 95%CI were 1.840-3.570 and 1.372-2.691,respectively. Combined plasma NO and cGMP levels predicted poor prognosis of children with left-right shunt congenital heart disease with AUC of 0.929（95%CI：0.865~0.969）and Yoden index of 0.811,which were greater than those predicted by the two alone. Conclusion Plasma NO and cGMP are down-regulated in children with left-to-right shunt congenital heart disease,which is closely related to the disease and will increase the risk of poor prognosis,and the combined prediction of poor prognosis is reliable.

Key words： left to right shunt congenital heart disease in children nitric oxide cyclic guanosine phosphate prognosis predictive value

Received: 19 April 2023

PACS:

R725.4

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	TANG Rongning
	TANG Wenlin

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TANG Rongning,TANG Wenlin. The expression levels of plasma NO and cGMP in children with left-to-right shunt congenital heart disease and their relationship with prognosis[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(5): 79-83.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I5/79

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