N端脑钠肽前体在小儿川崎病诊断中的价值  

Diagnostic value of NT-proBNP in children with Kawasaki disease

作　　者：杨芳[1] 陈琅[1] 沈晓丽[2] 郭薇[3] 

机构地区：[1]福建医科大学省立临床学院儿科,福建福州350001 [2]福建医科大学省立临床学院免疫实验室,福建福州350001 [3]福建医科大学省立临床学院心脏彩超室,福建福州350001

出　　处：《临床儿科杂志》2010年第7期630-632,共3页Journal of Clinical Pediatrics

基　　金：福建省卫生厅青年科研基金(No.2007-1-18)

摘　　要：目的观察N端脑钠肽前体(NT-proBNP)在小儿川崎病中的变化,探讨其在川崎病诊断中的价值。方法检测36例典型川崎病患儿和20例不完全川崎病患儿急性期、恢复期血浆NT-proBNP,另检测30例伴有发热并排除了心肌受累的呼吸道感染患儿和30例健康儿童的血浆NT-proBNP,并进行相互比较。同时对川崎病患儿急性期行心彩超检查。结果不完全川崎病组和典型川崎病组血浆NT-proBNP差异无统计学意义;两组川崎病组急性期血浆NT-proBNP明显高于呼吸道感染组和健康组,恢复期血浆NT-proBNP显著低于急性期;以血浆NT-proBNP>300pg/ml诊断川崎病,敏感性为80.35%,特异性为90.00%。川崎病组血浆NT-proBNP>300pg/ml的阳性率显著高于并发冠脉病变的阳性率。结论血浆NT-proBNP可以作为一项早期诊断川崎病的参考指标。Objective To observe the changes of NT-proBNP and to explore its diagnostic value in Kawasaki disease in children. Methods The plasma levels of NT-proBNP were detected in acute- and recovery-phase in 36 children with typical Kawasaki disease and 20 with incomplete Kawasaki disease respectively. Meanwhile the plasma levels of NT-proBNP were also detected in 30 children with respiratory tract infection with fever and without involvement of myocardium and in 30 healthy children. The plasma levels of NT-proBNP were compared between groups. The echocardiographic examination was performed in children with Kawasaki disease. Results The plasma levels of NT-proBNP were no significantly different between children with incomplete Kawasaki disease and children with typical Kawasaki disease. The plasma levels of NT-proBNP in acute-phase in children with incomplete Kawasaki disease and typical Kawasaki disease were clearly higher than that in children with respiratory tract infection and healthy children. The plasma levels of NT-proBNP in recovery-phase were significantly lower than that in acute-phase in children with Kawasaki disease. When diagnosis of Kawasaki disease was made by plasma level of NT-proBNP 〉 300 pg/ml, the sensitivity and specificity were 80.35%, 90.00%, respectively. The positive rate of plasma level of NT-proBNP 〉 300 pg/ml was significantly higher than that complicated by coronary lesion. Conclusions The plasma level of NT-proBNP could be used as a reference index in early diagnosis of Kawasaki disease.

关 键 词：N端脑钠肽前体 川崎病 诊断 冠脉病变 

分 类 号：R725.4[医药卫生—儿科]