NT-proBNP在儿童左向右分流型先天性心脏病中的临床价值  

Clinical Value of NT-pro BNP in Children with Left to Right Shunt Congenital Heart Disease

作　　者：朱英杰 李亚蕊[1,2] Zhu Yingjie;Li Yarui(Department of Pediatrics,Shanxi Medical University,Shanxi 030001,China)

机构地区：[1]山西医科大学儿科医学系,太原030001 [2]山西省儿童医院心血管及风湿免疫科,太原030001

出　　处：《医学研究杂志》2019年第9期164-168,180,共6页Journal of Medical Research

摘　　要：目的探讨早期检测血清BNP水平在左向右分流型先天性心脏病患儿的诊疗、病情严重程度及预后评估的价值。方法选取山西省儿童医院心血管内科诊断左向右分流型先天性心脏病患儿245例,其中男患儿122例,女患儿123例,年龄在1~146个月,平均年龄20.96±21.16个月;根据患儿的病情将其分为两组,即肺动脉压力正常组(A组)、肺动脉高压组(B组);其中每组均分为3个亚组,分别为单纯先心组(A1组、B1组)、合并肺炎组(A2组、B2组)、合并肺炎心力衰竭组(A3组、B3组)。在患儿入院后24h内测量血清BNP、CRP、PCT水平,入院48h内行心脏超声检查。结果血清BNP水平:B组(肺动脉高压组)明显高于A组(肺动脉压力正常组),P<0.05;A3组>A2组>A1组,P<0.05;B3组>B2组>B1组,P<0.05;各组血清BNP水平与CRP、PCT不呈线性关系,r<0.1;B组(肺动脉高压组)血清BNP水平与肺动脉压力呈低度正相关(r=0.418,P<0.05);B1组血清BNP水平与肺动脉压力呈正相关(r=0.506,P<0.05);ROC曲线提示血清BNP水平对先天性心脏病患儿是否合并肺动脉高压,是否合并肺炎,合并肺炎后是否发生心力衰竭有诊断价值。结论早期检测血清BNP水平对左向右分流型先天性心脏病患儿的诊断、治疗、病情严重程度评估及预后有重要价值。Objective To investigate the value of BNP detection for early in the diagnosis,treatment,severity and prognosis of children with left-to-right shunt congenital heart disease.Methods Totally 245 children with left to right congenital heart disease diagnosed by cardiovascular medicine in Shanxi Children′s Hospital were selected,including 122 males and 123 females,aged from 1 month to 146 months,with an average age of 20.96±21.16 months.The children were divided into two groups according to their condition:normal pulmonary artery pressure group(group A)and pulmonary hypertension group(group B).Each group was divided into three subgroups:simple congenital heart group(A1 group,B1 group),combined pneumonia group(A2 group,B2 group),combined pneumonia heart failure group(A3 group,B3 group).Serum levels of BNP,CRP and PCT were measured within 24 hours after admission,and echocardiography was performed within 48 hours after admission.Results The levels of serum BNP in Group B(pulmonary hypertension group)was significantly higher than that in group A(normal pulmonary artery pressure group),P<0.05;levels of serum BNP:group A3>group A2>groupA1,P<0.05;group B3>group B2>group B1,P<0.05;the levels of serum BNP in each group were not linearly correlated with the levels of CRP and PCT,r<0.1;The levels of serum BNP in group B(pulmonary hypertension group)was positively correlated with pulmonary artery pressure(r=0.418,P<0.05);the levels of serum BNP in group B1 were positively correlated with pulmonary artery pressure(r=0.506,P<0.05).ROC curves suggest that levels of serum BNP is valuable in the diagnosis of congenital heart disease in children with pulmonary hypertension,pneumonia and heart failure after pneumonia.Conclusion The levels of serum BNP with early detection is of great value in the diagnosis,treatment,severity and prognosis of children with left to right shunt congenital heart disease.

关 键 词：B型尿钠肽 先天性心脏病 肺动脉压力 肺炎 心力衰竭 

分 类 号：R725.4[医药卫生—儿科]