N T-proBN P对川崎病的诊断价值

目的：观察 N 端脑钠肽前体（NT‐proBNP）在小儿川崎病（KD）中的变化及临床诊断价值。方法选取该院KD患儿91例（KD组），以同期住院的80例呼吸道感染伴发热并排除心肌受累的患儿为对照组，分别测定KD急性期血浆NT‐proBNP水平，并分析其与不同的临床和实验室资料的关系。结果 KD组NT‐proBNP水平为（1042．38±528．7） pg／mL ，明显高于对照组（458．6±412．3）pg／mL ，差异有统计学意义（P＜0．05）。直线相关分析显示，KD患儿急性期血浆NT‐proBNP水平与CRP水平呈正相关（ r＝0．442，P＜0．05 ），与血细胞比容、血钠及血清蛋白呈负相关（分别为 r＝－0．216，P＝0．045；r＝－0．204，P＝0．041；r＝－0．315，P＝0．0003）。NT‐proBNP诊断KD的ROC曲线下面积为0．881，诊断界值530 pg／mL ，特异性和灵敏度分别为70．1％、84．0％。结论 KD急性期NT‐proBNP明显升高，可作为诊断KD的一个可靠指标，并且高水平的NT‐proBNP与系统性炎症相关。

Diagnostic value of NT-proBNP in Kawasaki disease

Objective To explore the diagnostic value of N‐terminal Pro‐Brain Natriuretic Peptide (NT‐proBNP) in Kawasaki disease (KD) in children .Methods Ninety one children with KD were collected and 80 patients with acute upper respiratory infec‐tion were used as controls .Plasma NT‐pro BNP concentrations and other laboratory date were collected in the acute of KD .The re‐lationships between NT‐pro BNP values and different clinical and laboratory data in the acute phase were sought .Results The mean plasma NT‐pro BNP concentration in patients with KD in the acute phase was (1 042 .38 ± 528 .7)pg/mL ,significantly higher than those of control group(458 .6 ± 412 .3)pg/mL (P<0 .05) .The results of linear correlation analysis indicated that plasma NT‐pro BNP was positively correlated with CRP (r= 0 .442 ,P< 0 .05) ,and negatively correlated with Hematocrit ,Albumin and Na (r= -0 .216 ,r= -0 .204 ,r= -0 .315 ,respectively ;P<0 .05) .According to ROC analysis ,the AUC of NT‐pro BNP for detection of KD were 0 .881 ,sensitivity and specificity was 70 .1% and 84 .0% respectively for the cut‐off value of 530 pg/mL .Conclusion Our findings showed that NT‐proBNP would elevate in the acute stage of KD and was a reliable marker for the diagnosis of KD .A high level of NT‐pro BNP is associated with systemic inflammatory responses and increased vascular permeability .