N端脑钠肽原在新生儿窒息合并心力衰竭诊断中的价值  

Values of NT-proBNP in diagnosing neonatal asphyxia complicated with heart failure

作　　者：靳彩虹 连喜院 李宏科 武洋 郭会萍 万改红 Jin Caihong;Lian Xiyuan;Li Hongke;Wu Yang;Guo Huiping;Wan Gaihong(Department of Biochemistry;Gansu Medical College,Lanzhou 744000,China)

机构地区：[1]甘肃医学院生物化学教研室,平凉744000 [2]甘肃省平凉市人民医院新生儿科

出　　处：《山西医药杂志》2018年第1期10-13,共4页Shanxi Medical Journal

基　　金：甘肃省高等学校科学研究项目(2015B-138)

摘　　要：目的检测窒息合并心力衰竭新生儿血中N端脑钠肽原(NT-proBNP)浓度,探讨NT-proBNP在新生儿窒息合并心力衰竭中的诊断价值。方法随机选择56例窒息患儿为研究对象(轻度窒息31例,重度窒息25例;其中无心力衰竭组29例,心力衰竭组27例),另设25名健康新生儿为对照组。采用免疫荧光层析法测定血浆NT-proBNP水平,同时检测肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)、肌红蛋白(Myo)及心电图、胸部X线等。结果心力衰竭组患儿血浆NT-proBNP明显高于无心力衰竭组和对照组(P<0.01),无心力衰竭组NT-proBNP水平与对照组比较升高,差异有统计学意义(P<0.05);重度窒息组NT-proBNP与轻度窒息组和对照组比较均显著升高(P<0.01),轻度窒息组NT-proBNP水平与对照组比较升高,差异有统计学意义(P<0.05);NT-proBNP诊断心力衰竭的敏感度优于cTnI、CK-MB和Myo,但差异均无统计学意义(P>0.05),NT-proBNP诊断心力衰竭的特异度优于CK-MB及Myo,差异有统计学意义(P<0.05),与cTnI比较差异无统计学意义(P>0.05);血浆NT-proBNP水平与cTnI、CK-MB及Myo呈正相关(P<0.01)。结论 NT-proBNP可作为诊断新生儿窒息合并心力衰竭的理想标志物,早期测定NT-proBNP对新生儿窒息是否合并心力衰竭有判断或预测作用。Objective To test the concentration of NT-proBNP in blood of the patients with neonatal asphyxia complicated with heart failures,and to explore the values of NT-proBNP in the diagnosis.Methods Firstly,56 infant patients with the neonatal asphyxia were selected randomly as the research subjects(31 of them with mild choking,25 with the severe asphyxia;29 of them were without heart failures and 27 were diagnosed with heart failures).Secondly,the other 25 healthy newborns were chosen as the control group.Then immunochromatography was adopted to test the level of NT-proBNP in the subjects'blood,along with their CK-MB,cTnI,Myo,ECG and their chest X-ray,etc.Results The level of NT-proBNP in the blood of the patients with heart failures is significantly higher than that of the group without heart failures or that of the control group(P<0.01).The NT-proBNP level of the group without heart failures rises higher than that of the control group and the differences were of statistical significance(P<0.05);The NT-proBNP level of the severe-asphyxia group is significantly higher than that of both the mild asphyxia group and the control group(P<0.01).The NT-proBNP level of the mild-asphyxia group is significantly higher than that of the control group(P<0.05),with statistical significance;The sensitivity of NT-proBNP in diagnosing heart failures overmatches cTnI,CK-MB and Myo,with no statistical significance(P>0.05).The specificity of NT-proBNP is better than that of CK-MB and Myo,with statistical significance(P<0.05).There is no significance compared with cTnI(P>0.05);The NT-proBNP level in the blood is positively correlated with that of cTnI,CK-MB and Myo(P<0.01).Conclusion NT-proBNP is the ideal marker in diagnosing neonatal asphyxia complicated with heart failures and the early test on NT-proBNP in the newborn infants'blood can be used to judge and predict whether the infants are suffering neonatal asphyxia complicated with heart failures.

关 键 词：新生儿窒息 心力衰竭 NT-PROBNP 诊断价值 

分 类 号：R722.1[医药卫生—儿科]