氮末端脑钠素原评价小儿心力衰竭的临床研究

目的研究血清氮末端脑钠素原(NT-Pro-BNP)与小儿心力衰竭之间的关系,为临床诊断和治疗小儿心力衰竭提供生物学参考依据。方法收集我科2004年3月~2005年3月102例不同心功能患儿,其中男67例,女35例;平均年龄(5.6±4.6)岁。按心功能分组。检测所有患儿血清NT-Pro-BNP水平、左心室射血分数(LVEF)和左心室缩短分数(LVFS)。结果NT-Pro-BNP值呈对数正态分布,随心衰加重,NT-Pro-BNP水平依次升高。LVEF值与NT-Pro-BNP对数值呈负相关(r=-0.221)。NT-Pro-BNP可以反映心衰程度。以NT-Pro-BNP值200 pg/ml作为区分有无心衰的临界点,心衰诊断的灵敏度为84.9%,特异度87.8%。LVEF、LVFS反映小儿心衰程度不敏感。结论血NT-Pro-BNP水平可反映心衰程度,并可依据其水平进行心衰分级。

The clinical study of NT-Pro-BNP in pediatric patients with cardiac failure

Objective Providing a biological criterion for diagnosing cardiac failure through analyzing the relationship between N-terminal pro-B-type natriuretic peptide(NT-Pro-BNP) concentration in serum and the grade of cardiac failure in children.Methods One hundred and two cases((67) for male,(35) for female)who had different heart functions in our department were collected,average age was 5.6 years old.They were divided into 5 groups according to the degree of cardiac function.NT-Pro-BNP were determined at the same time.Left ventricular ejection fraction(LVEF) and left ventricular fraction shorting(LVFS) were acquared through ultracardiography in all the patients.Results The datas of NT-Pro-BNP were skewed but the logarithms of which were normal distribution.The concentrations of NT-Pro-BNP in serum were developed successively along with the severity of cardiac function.The value of LVEF was correlated with the value of Log NT-Pro-BNP(r=-0.221).NT-Pro-BNP of 200pg/ml in serum could be looked as a checkpoint to differentiate the heart failure and the sensitivity and specificity of diagnosing heart failure were 84.9% and 87.8%,but LVEF and LVFS couhd not reflect the cardiac function sensitively.Conclusion The concentration of NT-Pro-BNP in serum can reflect the cardiac function sensitively but LVEF and LVFS are limited.