BNP And LVEF's Evaluation In Children With High Altitude Heart Disease In Terms Of Heart Function

Objective:To analyze the changes of brain natriuretic peptide,left ventricular ejection fraction,fraction shortening and pulmonary arterial pressure in children with high altitude heart disease and to evaluate the indicators'clinical value in children with high altitude heart disease in terms of heart function.Methods:A total of 330 children who were hospitalized in our department and diagnosed as high altitude heart disease from January 2014 to December 2017 were selected,which were consistent with the1995diagnostic criteria for children with high altitude heart disease^[1].At the time of admission,the scores were scored according to the modified ROSS score table.Then,all cases were divided into no heart failure group,mild heart failure group,moderate heart failure group,severe heart failure group.Examinationshouldincludebrainnatriureticpeptideand echocardiography.Then,the relationship between brain natriuretic peptide,left ventricular ejection fraction,fraction shortening,and pulmonary artery pressure was compared between the groups.Results:?1?The ethnic groups distributed 93.93%of Tibetans,4.54%of Hans,1.51%of Huis,93.3%of those aged?2 years old.Those of children without heart failure,mild heart failure,moderate heart failure,and severe heart failure,for comparison,P>0.05,there was no significant difference in age between the groups.Therefore,the age distribution of each group was the same.The overall ratio of male to female was 1:0.82,and the ratio of male to female in each group for comparison,P>0.05.Therefore,the proportion of males and females in each group was the same in this study.In the data analysis of hospitalization time,the number of cases in which the number of cases of automatic discharge was excluded was 63 cases in the group without heart failure,78 cases in the mild heart failure group,80 cases in the moderate heart failure group,and severe heart failure group including 46 patients.The hospitalization time of each group was compared,P>0.05,that is,there was no significant difference in hospitalization time between the groups.Therefore,the hospitalization time distribution of each group was considered to be the same.?2?The number of red blood cells in each group was compared,P>0.05,the difference was not statistically significant,so the overall mean of red blood cells in each group was considered to be equal;the hemoglobin of each group was compared,P>0.05,the difference was not statistically significant,so the overall mean of hemoglobin was considered to be equal in each group;the hemoglobin range was calculated from 105.4-152.4 g/L^[B6],and the hemoglobin value of 43.6%of children was less than 105.4 g/L,the hemoglobin value of 51.6%children was in the normal range,the hemoglobin value of children in 4.8%was higher than 152.4g/L.The red blood cell range was calculated from 4.36-5.84×10¹²/L^[B6],and the number of red blood cells in 17.0%of children was lower than 4.36×10¹²/L,61.2%of the children had red blood cell counts in the normal range,and 21.8%of the children had red blood cell counts higher than 5.84×10¹²/L.?3?The levels of brain natriuretic peptides in each group were compared,P<0.05,and the difference was statistically significant.Therefore,the levels of brain natriuretic peptides in each group were not the same.According to the specific values of the median?quartile?of each group in Table 3,it can be seen that the more severe the degree of heart failure,the higher the level of brain natriuretic peptide.?4?The left ventricular ejection fraction of each group was compared,P<0.05,the difference was statistically significant,so the levels of ejection fraction were not the same in each group;the fraction shortening of each group was compared,P<0.05,the difference was statistically significant,so the level of fraction shortening of each group was not the same.?5?Pulmonary arterial pressure in each group,P<0.05,the difference was statistically significant,so the level of pulmonary artery pressure was not the same in each group.Conclusions:?1?The proportion of males and females in children with high altitude heart disease is not much different.The age of onset is mostly below 2 years old,and the proportion of local Tibetan children is the highest.?2?Brain natriuretic peptide is of high value in the assessment of children with high altitude heart disease.?3?Left ventricular ejection fraction and fraction shortening of children with high altitude heart disease may decrease during the process of cardiac function deterioration,it shouldbe used as an index to evaluate cardiac function changes.?4?Pulmonary arterial pressure has a tendency to increase with the increase of heart failure.Children with higher pulmonary artery pressure should be more alert to heart failure.