血清氮端脑钠肽及脑钠肽在新生儿败血症合并心肌损伤时的临床意义

目的探讨脑钠肽（BNP）及氮端脑钠肽（NT-proBNP）在新生儿败血症心肌损伤诊断中的价值。方法选择37例新生儿败血症合并心功能异常患儿作为病例组,15例健康新生儿作为对照组参与本研究,采用ROSS新生儿心功能分级将患儿分为心功能Ⅰ、Ⅱ和Ⅲ级;采用心脏超声检测患儿左室射血分数（LVEF）;检测患儿血浆BNP及NT-proBNP水平,并在不同心功能分级患儿以及正常新生儿之间进行比较。结果病例组血浆BNP及NT-proBNP水平较对照组显著升高,差异具有统计学意义（P〈0.05）;随着患儿心功能评级的上升,血浆BNP及NT-proBNP水平水平不断显著升高,LVEF不断显著降低,差异均具有统计学意义（均P〈0.05）;在心功能Ⅰ级患儿,血浆NT-proBNP的升高率显著高于BNP升高率（P〈0.05）。结论血浆BNP及NT-proBNP水平可作为新生儿败血症心肌损伤诊断的良好辅助指标;对于早期心肌损伤的诊断,NT-proBNP优于BNP。

Clinical significance on detection of serum NT-proBNP and BNP in diagnosis of cardiac injury in neonatal sepsis

Objective To explore the value of detection of BNP and NT-proBNP in neonatal sepsis.Methods 37 cases of neonatus with neonatal sepsis and abnormal cardiac function were selected as case group and 15 healthy neonates as control group were selected.ROSS classification was applied to put patients into classⅠ,Ⅱ,Ⅲ;LVEF was tested by cardiac ultrasound;levels of BNP and NT-proBNP among class Ⅰ,Ⅱ,Ⅲ and control group were detected and compared.Results Increased levels of BNP and NT-proBNP were found significantly in case group than in control group(P < 0.05);along with upgrade of cardiac function classification and decrease of LVEF,increased levels of BNP and NT-proBNP were found significantly(P < 0.05);in cardiac function class I,increase rate of NT-proBNP was found significantly higher than that of BNP(P < 0.05).Conclusion Detection of BNP and NT-pro BNP could be utilized as auxiliary indexes in diagnosis of cardiac injury in neonatal sepsis;detection of NT-proBNP is more valuable than BNP in diagnosis of early stage cardiac injury in neonatal sepsis.