实用医学杂志 ›› 2021, Vol. 37 ›› Issue (14): 1832-1836.doi: 10.3969/j.issn.1006⁃5725.2021.14.012

• 临床研究 • 上一篇    下一篇

儿童主动脉缩窄术后血压异常与内皮功能损害的关系

曾洁敏1,2, 黄萍2,卢根1, 童志杰1, 王红英3 ,冯浩然4   

  1. 广州市妇女儿童医疗中心1 儿童呼吸内科,2 儿童心脏中心,3 儿童超声科,4 中心实验室(广州 510623)
  • 出版日期:2021-07-25 发布日期:2021-07-25
  • 通讯作者: 卢根 E⁃mail:lugen5663330@sina.com
  • 基金资助:

    广州市卫生健康科技一般引导项目(编号:20201A011026)

Relationship between abnormal blood pressure and endothelial disfunction in children after operation on coarctation of aorta 

ZENG Jiemin*,HUANG Ping,LU Gen,TONG Zhijie,WANG Hongying,FENG Haoran.   

  1. Department of Respiratory,Guangzhou Women and Children′s Medical Center,Guangzhou 510623,China

  • Online:2021-07-25 Published:2021-07-25
  • Contact: LU Gen E⁃mail:lugen5663330@sina.com

摘要:

目的 观察儿童主动脉缩窄术后血压异常的情况,并探讨其与内皮功能损害的关系。 方法 选取 23 例主动脉缩窄(coarctation of the aorta,CoA)患儿,20 例健康儿童(健康组)作对照,均于基 线(术后 1 周)、8 年随访(术后 8 年)监测血压、超声下右肱动脉充血性反应后血流介导的舒张功能(flow⁃ mediated dilation,FMD)、血清可溶性 E 选择素(soluble E⁃selectin,sE⁃selectin)。按照 8 年随访时的血压,将主动脉缩窄儿童分为术后血压异常组[CoA BP(+)组]和术后血压正常组[CoA BP(-)组]。结果 8 随访中,41.18%的主动脉缩窄儿童出现血压异常,其中 5 例为血压升高,2 例达到高血压标准。CoA BP(+ 组、CoA BP(-)组在基线及 8 年随访的 FMD 均低于同期的健康组(P < 0.05),而 CoA BP(+)组的 FMD 低于 同期的 CoA BP(-)组(P < 0.05)。CoA 两个亚组在基线及 8 年随访的 sE⁃selectin 均高于同期的健康组(P < 0.01),而 CoA BP(+)组的 sE⁃selectin 高于同期的 CoA BP(-)组(P < 0.01)。结论 本研究发现部分主动脉 缩窄儿童在术后长期随访中出现血压异常,与术后血压正常的儿童相比,术后血压异常的儿童血管内皮 功能损害更明显。

关键词: 主动脉缩窄,  , 血压,  , 血管内皮功能

Abstract:

Objective To observe the abnormal blood pressure in children after operation on coarctation of aorta (CoA),and explore the relationship between abnormal blood pressure and endothelial disfunction. Methods We enrolled 23 children with CoA who underwent surgery between January and October in 2010 in Guangzhou Women and Children′s Medical Center and 20 health children. According to blood pressure(BP)results during an 8⁃ year follow ⁃ up ,children with CoA were divided into a post ⁃ operative abnormal blood pressure group(CoA BP(+)group)and a post⁃operative normal blood pressure group(CoA BP(⁃)group). All participants underwent measurements of systolic blood pressure(SBP),diastolic blood pressure(DBP),echocardiography,flow⁃ mediated dilation(FMD)of the right brachial artery,and serum soluble E⁃selectin(sE⁃selectin)at baseline(1 week after surgery)and during an 8⁃year follow⁃up(after surgery). Results We collected data from the 8⁃year follow⁃up of 17 children with CoA and 15 health children. 41.18% of the children with CoA had abnormal blood pressure amongst which 5 had elevated blood pressure and 2 met the hypertension standard. There were no differences in DBP among there groups at baseline and 8⁃year follow⁃up(P > 0.05). Both CoA BP(+)children and CoA BP(-)children had decreased FMD and higher serum levels of sE⁃selectin than health children at baseline and during the 8⁃year follow⁃up(P < 0.05). And CoA BP(+)children had decreased FMD and higher serum levels of sE⁃selectin than CoA BP(-)children at baseline and 8⁃year follow⁃up(P < 0.01). Conclusion Some children after operation on CoA had abnormal BP during a long⁃term follow⁃up. Compared with children with normal BP after CoA surgery,chil⁃ dren with abnormal BP after CoA operation had more obvious vascular endothelial dysfunction. 

Key words:

coarctation of the aorta, blood pressure, vascular endothelial function