重症肺炎患儿血清H-FABP、CK-MB和NT-proBNP水平对评价心肌损害的临床意义  

Clinical significance of serum H⁃FABP,CK⁃MB and NT⁃proBNP levels in children with severe pneumonia in evaluating myocardial damage

作　　者：闫焕利 闫瑞雪 彭富栋[1] 李洪双[1] 史静[1] YAN Huanli;YAN Ruixue;PENG Fudong;LI Hongshuang;SHI Jing(Department of Neonatology,Liaocheng Second People's Hospital,Liaocheng,Shandong,China,252600)

机构地区：[1]聊城市第二人民医院新生儿科,山东聊城252600

出　　处：《分子诊断与治疗杂志》2023年第7期1125-1128,共4页Journal of Molecular Diagnostics and Therapy

基　　金：聊城市科技发展计划项目(2019GJH3991)。

摘　　要：目的探究重症肺炎患儿血清心型脂肪酸结合蛋白(H⁃FABP)、磷酸肌酸激酶同工酶(CK⁃MB)及N末端B型利钠肽(NT⁃proBNP)水平对评价心肌损害的临床意义。方法选取2019年6月至2022年6月聊城市第二人民医院收治的重症肺炎患儿150例作为实验组,根据是否出现心肌损害分为损害组(n=81)和非损害组(n=69),另选同期于本院体检的健康患者70名作为正常组。检测所有受试者血清H⁃FABP、CK⁃MB和NT⁃proBNP水平,并通过ROC曲线分析H⁃FABP、CK⁃MB和NT⁃proBNP水平在评估患儿心肌损害的敏感度、特异度及准确性。结果实验组患儿血清H⁃FABP、CK⁃MB和NT⁃proBNP水平明显高于正常组,差异有统计学意义(t=22.997、45.266、66.795,P<0.05);损害组患儿血清H⁃FABP、CK⁃MB和NT⁃proBNP水平明显高于非损害组,差异有统计学意义(t=15.135,24.945,48.036,P<0.05);根据ROC曲线分析结果可知,H⁃FABP+CK⁃MB+NT⁃proBNP联合检测的敏感度为92.59%,特异度为94.20%,准确度为93.33%,三者联合检测的敏感度、特异度及准确度明显高于H⁃FABP、CK⁃MB、NT⁃proBNP单独检测(P<0.05)。结论重症肺炎患儿发生心肌损害时血清H⁃FABP、CK⁃MB和NT⁃proBNP水平明显增加,检测血H⁃FABP、CK⁃MB和NT⁃proBNP水平变化,对于评估重症肺炎患儿是否发生心肌损害具有重要价值。Objective To explore the clinical significance of serum levels of heart⁃type fatty acid binding protein(H⁃FABP),creatine kinase isoenzyme(CK⁃MB)and N⁃terminal B⁃type natriuretic peptide(NT⁃proBNP)in children with severe pneumonia in evaluating myocardial damage.Methods 150 children with severe pneumonia admitted to the Second People's Hospital of Liaocheng City from June 2019 to June 2022 were selected as the experimental group.According to whether myocardial damage occurred,they were divided into the damage group(n=81)and the non⁃damage group(n=69),and 70 healthy patients who under⁃went physical examination in our hospital at the same time were selected as the normal group.Serum levels of H⁃FABP,CK⁃MB and NT⁃proBNP were measured in all subjects.The sensitivity,specificity,and accuracy of H⁃FABP,CK⁃MB and NT⁃proBNP levels in evaluating myocardial damage in children were analyzed by ROC curve.Results The serum levels of H⁃FABP,CK⁃MB and NT⁃proBNP in the experimental group were significantly higher than those in the normal group(t=22.997,45.266,66.795,P<0.05).The serum levels of H⁃FABP,CK⁃MB and NT⁃proBNP in the injured group were significantly higher than those in the non⁃injured group(t=15.135,24.945,48.036,P<0.05).According to the analysis of ROC curve,the sensitivity and specificity of the combined detection of H⁃FABP+CK⁃MB+NT⁃proBNP were 92.59%and 94.20%,respective⁃ly.The sensitivity,specificity and accuracy of combined detection were significantly higher than those of H⁃FABP(P<0.05).Conclusion Serum levels of H⁃FABP,CK⁃MB and NT⁃proBNP are significantly increased in children with severe pneumonia when myocardial damage occurs.Detecting the changes of serum levels of H⁃FABP,CK⁃MB and NT⁃proBNP is of great value in evaluating myocardial damage in children with severe pneumonia.

关 键 词：重症肺炎 心型脂肪酸结合蛋白 磷酸肌酸激酶同工酶 N末端B型利钠肽 心肌损害 

分 类 号：R725.6[医药卫生—儿科]