肺炎并心力衰竭婴幼儿血清心肌肌钙蛋白Ⅰ和脑钠肽变化及其与心功能的关系  

Changes of Serum Cardiac Troponin I and Brain Natriuretic Peptide in Pediatric Heart Failure with Pneumonia and Their Relationship with Heart Function

作　　者：朱艳萍[1] 杨巧芝[1] 陆诗祥[1] 秦道刚[1] 周阔[1] 

机构地区：[1]聊城市人民医院儿科,山东聊城252000

出　　处：《实用儿科临床杂志》2008年第13期1013-1014,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨肺炎并心力衰竭（肺炎心衰）婴幼儿血清心肌肌钙蛋白I（cTnI）和脑钠肽（BNP）水平变化及其与心脏收缩功能的关系。方法随机选取体检健康儿童30例（健康对照组）。男17例,女13例;年龄5个月~3岁。同期选择重症肺炎心衰患儿30例（肺炎心衰组）。男21例,女9例;年龄3个月~2岁。一般肺炎患儿30例（一般肺炎组）。男16例,女14例;年龄3个月~3岁。抽取各组患儿静脉血2~3mL分别以酶联免疫吸附法（ELISA）及微粒子免疫发光法（MEIH）测定血清BNP、cTnI水平。同时均行心脏超声测定其左室射血分数（LVEF）和左室短轴缩短率（LVFS）。采用SPSS 11.0软件进行统计学分析。结果肺炎心衰组血清cTnI[（0.389±0.030）ng/L]和BNP[（0.572±0.090）μg/L]水平升高,LVEF和LVFS水平降低;与一般肺炎组和健康对照组比较均有显著性差异（Pa〈0.05）;肺炎心衰组血清cTnI与LVEF和LVFS均呈直线负相关（r=-0.87,-0.76 Pa〈0.05）;肺炎心衰组血清BNP水平与LVEF和LVFS亦均呈直线负相关（r=-0.97,-0.85 Pa〈0.05）。结论血清cTnI和BNP水平可作为判断肺炎心衰患儿心肌损害及心衰程度的指标。Objective To investigate the changes of serum cardiac troponin I（cTnI） and brain natriuretic peptide（BNP） in heart failure of children with pneumonia and their relationship with heart function. Methods Thirty healthy children aged from 5 months to 3 years old were randomly selected with 17 male and 13 female （healthy group）. Thirty children with severe heart failure aged from 3 months to 2 years old were selected at the same time with 21 male and 9 female （heart failure group）. Thirty children with ordinary pneumonia aged from 3 months to 3 years old were also sampled with 16 male and 14 female （ ordinary pneumonia group）. The peripheral bloods of 2 - 3 mL of all children were taken. The BNP level were measured by enzyme - linked immunosorbent assay and the cTnI level was determined by micro - particle enzyme immunoluminescent. Left ventricular ejection fraction（LVEF） and left ventricular fractional shor-tening （LVFS） were detected by echocardiography. SPSS 11.0 software was used to analyze the data. Results The levels of cTnI [ （0. 389 ± 0.030 ） μg/L ] and BNP [ （0. 572 ± 0.090） μg/L ] of heart failure group increased significantly compared with healthy and ordinary pneumonia group, while their LVEF and LVFS decreased significantly （ Pa 〈 0.05 ）. There were linear negative correlation not only between cTnI and LVEF but also between cTnI and LVFS in heart failure group （ r = - 0.87, - 0.76 Pa 〈 0.05 ）. Similarly, there were linear negative correlation exists not only between BNP and LVEF but also between BNP and LVFS in heart failure group （ r = 0.97, - 0.85 Pa 〈 0.05 ）. Conclusion Serum cTnI and BNP can be used as index evaluating the myocardial damage and cardiac dysfunction in pediatric heat failure with pneumonia.

关 键 词：肺炎 心力衰竭 心肌肌钙蛋白I 脑钠肽 心功能 

分 类 号：R725.4[医药卫生—儿科]