| Objective:To observe the level of (BNP) and its precursor (NT-pro-BNP) before and after the surgery in children with congenital heart disease, and evaluate the early heart function. Focus on research ascending aortic clamp time, intraoperative body temperature, cooling time and CPB time of cardiac function before and after surgery.Methods:To select 40 cases of children with heart disease lived in the Guangdong Armed Police Corps Hospital from 2008.7 to 2009.1,and acquired the venous blood at pre-CPB, at the end of CPB and 24 hours after CPB repectively, then separated out the plasma and to freeze it in-70℃refrigerator.At the same time choose 30 cases of healthy control in the same period in the hospital and acquired the venous blood. To detect the concentration of (BNP) and its precursor (NT-pro-BNP) of the plasma using the method of enzyme-linked immunosorbent assay.Results:The concentration of BNP and NT-pro-BNP in the group with heart disease is 315.45±120.45 pg/ml,331.67±131.83 pg/ml, in the control group is 11.65±8.66pg/ml,53.12±23.90pg/ml respectively, the comparetion between the two groups have statistically significance(P= 0.000); the concentration in the end of CPB in the group with heart disease is 165.91±65.65pg/ml,182.50±65.35 pg/ml, compared with the pre-CPB, the difference was statistically significant (P= 0.000); 24 hours after CPB is 439.08±154.75pg/ml,460.29±167.85pg/ml, higher than those in pre-CPB, and compared with the pre-CPB the difference was statistically significant (P= 0.000). Using multiple linear regression analysis, aortic clamping time factor is not selected.At the end of CPB, plasma BNP concentration and intraoperative body temperature were negatively correlated (correlation coefficient R=0.379, partial regression equation Y1= 434.042-10.061X1); plasma NT-pro-BNP concentration and duration of intraoperative hypothermia were a negative correlation (R= 0.442, Y2= 493.096-11.655X2). After 24 hours of the surgery, the plasma BNP concentration was positively correlated with CPB time, and negatively correlated with duration of intraoperative hypothermia (R= 0.635, Y3= 248.38+3.51 X3-2.84X4), the standard deviation of CPB time and duration of intraoperative hypothermia were 1.302 and-0.754, the standard deviation of CPB time was bigger, so the role of CPB time on plasma BNP is greater than the duration of intraoperative hypothermia after 24 hours of the surgery; plasma NT-pro-BNP level was negatively correlation with duration of intraoperative hypothermia (R=0.588, Y4= 1523.31-39.89X5). The plasma of BNP and NT-pro-BNP levels of intraoperative body temperature≦ 28℃group was higher than> 28℃group at the end of CPB and after 24 hours of the surgery, the difference was significant (P <0.05). Comparing the cooling time of surgery, the plasma of BNP and NT-pro-BNP levels of≦40min group after 24 hours of the surgery was lower than>40min group,the difference was statistically significance (P<0.05); the difference was not statistically significant between two groups at the end of CPB. The plasma of BNP and NT-pro-BNP levels of CPB time≦60min group was lower than the CPB time>60min group at the end of CPB and after 24 hours of the surgery, the differences were significant (P<0.05).Conclusion:1.Using of the plasma of BNP or NT-pro-BNP levels to determine early cardiac function of children with congenital heart disease after cardiopulmonary bypass, it is timely to prevente heart failure and low cardiac output after surgery.2. The plasma of BNP and NT-pro-BNP levels were negatively correlation with operation temperature and the duration of intraoperative hypothermia, were positively correlation with CPB time.During the surgery, control the body temperature≧28℃(below 30℃), the cooling time≦40min and the CPB time≦60min have protective effect on cardiac function.
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