脑型利钠肽评估儿童扩张型心肌病急性失代偿性心力衰竭及心室重构的临床价值  

Clinical Value of Brain Natriuretic Peptide in Assessment of Acute Decompensated Heart Failure and Ventricular Remodeling in Children with Dilated Cardiomyopathy

作　　者：王丹[1] 钟家蓉[1] 张静[1] Wang Dan;Zhong Jiarong;Zhang Jing(Children＇ s Hospital of Chongqing Medical University,Key Laboratory of Pediatrics,Committee of Science and Technology in Chongqing,Key Laboratory of Developmental Diseases in Childhood,Ministry of Education,Chongqing International Science and Technology Cooperation Center for Child Development and Disorders,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院,儿科学重庆市重点实验室,儿童发育疾病研究教育部重点实验室,重庆市儿童发育重大疾病诊治与预防国际科技合作基地,重庆400014

出　　处：《儿科药学杂志》2018年第8期11-14,共4页Journal of Pediatric Pharmacy

摘　　要：目的:研究血清脑型利钠肽(BNP)用于评估儿童扩张型心肌病急性失代偿性心力衰竭(ADHF)、心室重构的临床价值。方法:收集2012年1月至2016年8月在重庆医科大学附属儿童医院诊治的40例合并ADHF的扩张型心肌病患儿的心功能(改良ROSS评分)、血清BNP、心脏彩超左心室射血分数(LVEF)、左室舒张末期直径(LVEDd)、室间隔厚度(IVSD)等资料。回顾性分析BNP在治疗前后的变化及与改良ROSS评分、LVEF、LVEDd、IVSD等相应指标的相关性。结果:BNP、改良ROSS评分、LVEF等在ADHF治疗前后比较,差异有统计学意义。ADHF治疗前BNP与改良ROSS评分呈正相关(R=0.975,P<0.01),与LVEF及IVSD呈负相关(P<0.05),与LVEDd相关性较弱(R=0.349,P<0.05)。ADHF治疗后BNP与改良ROSS评分仍然呈正相关(R=0.911,P<0.01),与LVEF呈负相关(R=-0.535,P<0.01),但BNP与LVEDd、IVSD等心室重构指标无明显相关性。结论:儿童扩张型心肌病血清BNP水平与ADHF严重程度密切相关,血清BNP水平结合改良ROSS评分和LVEF评价ADHF的发生发展有重要临床价值,而BNP水平评估儿童扩张型心肌病心室重构的临床价值有待进一步探究。Objective： To study the clinical value of serum brain natriuretic peptide（BNP） in assessment of acute decompensated heart failure（ ADHF） and ventricular remodeling in children with dilated cardiomyopathy. Methods： General information of forty children with ADHF and dilated cardiomyopathy admitted into Children＇s Hospital of Chongqing Medical University from Jan. 2012 to Aug. 2016 were collected,in terms of cardiac function（ modified ROSS score）,serum BNP and echocardiography（ LVEF,LVEDd,IVSD）,etc.Changes of BNP before and after treatment and the correlation with modified ROSS score,LVEF,LVEDd,IVSD and other related indicators were retrospectively analyzed. Results： There were significant differences in BNP,modified ROSS score,LVEF before and after treatment of ADHF. Before ADHF treatment,there was a positive correlation between BNP and modified ROSS score（ R = 0.975,P〈0.01）,and a negative correlation with LVEF and IVSD（ P〈0.05）,a slight correlation with LVEDd（ R = 0. 349,P〈0.05）. After ADHF treatment,BNP was still positively correlated with modified ROSS score（ R = 0. 911,P〈0.01）,and there was a negative correlation with LVEF（ R =-0.535,P〈0.05）,but there was no obvious correlation between BNP and LVEDd,IVSD representing left ventricular remodeling index. Conclusion： Serum BNP levels in children with dilated cardiomyopathy are closely related to the severity of ADHF,the serum BNP levels combined with modified ROSS score and LVEF has important clinical value in assessing the development and progression of ADHF,yet the clinical value of BNP levels in assessment of ventricular remodeling in children with dilated cardiomyopathy remains to be further explored.

关 键 词：儿童 扩张型心肌病 急性失代偿性心力衰竭 脑型利钠肽 心室重构 

分 类 号：R725.4[医药卫生—儿科]