氨基末端脑钠肽前体对新生儿肺炎心肌损伤的诊断价值  

Diagnostic value of plasma N-terminal pro-B-type natriuretic peptide in myocardial injury of pneumonia in newborn

作　　者：黄如章 梁杰昌 李焕琼 钟斌才 褐文球 

机构地区：[1]佛山市三水区人民医院儿科, 广东省528100

出　　处：《中国心血管病研究》2014年第2期118-121,共4页Chinese Journal of Cardiovascular Research

基　　金：佛山市科技局立项（项目编号：201108268）

摘　　要：目的 探讨新生儿肺炎并发心肌损伤时血中氨基末端脑钠肽前体（NT-proBNP）水平的变化,以及在不同胎龄儿中表达水平的差异,为新生儿肺炎并发心肌损伤提供早期诊断的可靠实验室指标.方法 将临床诊断为新生儿肺炎的患儿102例分为心肌损伤组和非心肌损伤组,入院第2、5天采用电化学发光法分别检测血中NT-proBNP水平,入院第5天同时检测肌酸激酶同功酶（CK-MB）、心肌肌钙蛋白T（cTnT）水平,比较两组患者NT-proBNP、CK-MB和cTnT的差异;同时分析不同胎龄儿血中NT-proBNP水平的差异.结果 新生儿肺炎第2天心肌损伤组和非心肌损伤组NT-proBNP值分别为（1203±362）pg/ml和（675±294）pg/ml,两组比较差异有统计学意义（P＜0.05）.第5天心肌损伤组和非心肌损伤组NT-proBNP值分别为（1893±475）pg/ml和（1075±330）pg/ml,两组比较差异有统计学意义（P＜0.05）.第5天心肌损伤组和非心肌损伤组cTnT值分别为（0.31±0.16）μg/L和（0.05±0.02）μg/L,两组比较差异有统计学意义（P＜0.05）;CK-MB两组间比较差异无统计学意义（P＞0.05）.不同胎龄儿中NT-proBNP值以早产儿最高,早产儿NT-proBNP值为（1428±407）pg/ml,三组比较差异有统计学意义（P＜0.05）.结论 新生儿肺炎发生心肌损伤时血氨基末端脑钠肽前体明显升高,可作为早期诊断的可靠实验室指标.不同胎龄儿中以早产儿NT-proBNP的血中基础值最高.Objective To investigate the myocardial damage of newborn pneumonia and serum N-termi- nal pro brain natriuretic peptide （NT-proBNP） levels, and the expression level in different gestational age, and reliable laboratory indicators. For early diagnosis of neonatal pneumonia complicated with myocardial injury to provide reliable laboratory indicators. Methods The clinical diagnosis of neonatal pneumonia 102 cases were divided into myocardial injury group and non-myocardial injury group. On the second day, fifth day of admission, the levels of NT-proBNP, CK-MB, cardiac troponin T（cTnT） in blood were detected by and the dif- ferences between the two groups were compared;At the same time the serumlevels of NT-preBNP level in different gestational age were compared. Results In myocardial injury group and non-myocardial injury group, the levels of NT-preBNP were （1203±362）pg/ml and （675±294）pg/ml separately on the second day of admission, （1893± 475 ）pg/ml and （1075±330）pg/ml on the fifth day of admissionthere were significant difference between two groups （P〈0.05）. On fifth day, in myocardial injury group and non myocardial injury group, cTnT values were （0.31± 0.16 ）μg/L and （0.05±0.02） μg/L, there was significant difference between two groups （P〈0.05） ; CK-MB had no statistically significant difference between two groups （P〉0.05）. The level of NT-proBNP in premature infants was the highest, NT-proBNP value was （1428±407）pg/ml, there was significant difference between three groups（P〈 0.05）. Conclusion The level of NT-proBNP increase significantly when the myocardial injury occurs in neonatal pneumonia, can be used as an early diagnosis of reliable laboratory indexes. The basis level of NT-preBNP is high- est in premature infant.

关 键 词：新生儿 肺炎 心肌损伤 氨基末端脑钠肽前体 心肌肌钙蛋白 

分 类 号：R542.2[医药卫生—心血管疾病]