cTnT、cTnⅠ、BNP及LVEF联合检测对先天性心脏病并发肺炎心力衰竭患儿的诊疗价值  

Value of combined detection of cardiac troponin T,troponin Ⅰ,B-type natriuretic peptide,and left ventricular ejection fraction in the diagnosis and treatment of children with congenital heart disease complicated with pneumonia and heart failure

作　　者：王栋[1] 秦艳妮[1] 景芳丽[1] WANG Dong;QIN Yan-ni;JING Fang-li(Department of Pediatrics,the Central Hospital of Xi'an City,Xi'an 710001,Shaanxi,CHINA)

机构地区：[1]西安市中心医院儿科

出　　处：《海南医学》2019年第15期1972-1974,共3页Hainan Medical Journal

摘　　要：目的探讨心肌钙蛋白T(cTnT)、肌钙蛋白I(cTnI)、B型钠尿肽(BNP)及左心室射血分数(LVEF)联合检测对先天性心脏病并发肺炎心力衰竭(简称“心衰”)患儿的诊疗价值。方法选取西安市中心医院2016年1月至2018年6月先天性心脏病并发肺炎心衰患儿85例和在本院体检的身体健康儿童25例作为研究对象,以先天性心脏病并发肺炎心衰患儿为观察组,其中单纯先天性心脏病患儿27例为A组,先天性心脏病并发肺炎患儿34例为B组,先天性心脏病并发肺炎心衰患儿24例为C组,身体健康儿童为对照组,检测并比较各组受检者的外周血cTnT、cTnI、BNP水平以及LVEF评分。结果观察组患儿的cTnT、cTnI、BNP水平分别为(0.59±0.08)ng/L、(0.49±0.13)ng/L、(327.3342±65.55)pg/mL,均明显高于对照组的(0.17±0.04)ng/L、(0.08±0.02)ng/L、(163.2724±16.94)pg/mL,差异均具有统计学意义(P<0.05);观察组患儿的LVEF评分为(59.48±6.20)分,低于对照组的(71.33±7.87)分,差异具有统计学意义(P<0.05);观察组中A组患儿的cTnT、cTnI、BNP水平最低,B组水平居中,C组最高,A组的LVEF评分最高,B组水平居中,C组最低,差异均具有统计学意义(P<0.05);cTnT、cTnI、BNP和LVEF联合检测的灵敏度和特异度均明显高于单独检测,差异均具有统计学意义(P<0.05)。结论cTnT、cTnI、BNP及LVEF联合检测儿童的先天性心脏病并发肺炎心衰的灵敏度和特异度较高,值得临床推广。Objective To investigate the value of the combined detection of cardiac troponin T(c Tn T), troponin I(c Tn I), B-type natriuretic peptide(BNP), and left ventricular ejection fraction(LVEF) in the diagnosis and treatment of congenital heart disease complicated with pneumonia heart failure(referred to as"heart failure"). Methods From January 2016 to June 2018, 85 children with congenital heart disease complicated with pneumonia and heart failure(the observation group) and 25 healthy children(the control group) in the Central Hospital of Xi’an City were selected as research subjects. The observation group were further divided into group A(27 patients with congenital heart disease), group B(34 patients with congenital heart disease complicated with pneumonia), and group C(24 patients with congenital heart disease complicated with pneumonia and heart failure). The healthy children were used as the control group, and the peripheral blood c Tn T, c Tn I, BNP levels, and LVEF scores of each group were detected and compared. Results The levels of c Tn T, c Tn I, and BNP in the observation group were(0.59±0.08) ng/L,(0.49±0.13) ng/L,(327.334 2±65.55) pg/m L, respectively, which were significantly higher than(0.17±0.04) ng/L,(0.08±0.02) ng/L,(163.272 4±16.94) pg/mL in the control group(P<0.05). The LVEF score of the observation group was 59.48±6.20, significantly lower than 71.33±7.87 of the control group(P<0.05). In group A, the levels of cTnT, cTnI, and BNP were the lowest in group A, and the highest in group C. The LVEF score was the highest in group A and the lowest in group C. The difference between the three groups was statistically significant(P<0.05). The sensitivity and specificity of the combined detection of cTnT,cTnI, BNP and LVEF were significantly higher than those of single index(P<0.05). Conclusion The combined detection of c TnT, cTnI, BNP and LVEF is sensitive and specific for detecting congenital heart disease complicated with pneumonia and heart failure in children. It is worth popularizing.

关 键 词：先天性心脏病 肺炎 心力衰竭 心肌钙蛋白T 肌钙蛋白Ⅰ B型钠尿肽 左心室射血分数 

分 类 号：R725.4[医药卫生—儿科]