不完全川崎病患儿N端脑钠肽前体及心肌肌钙蛋白I含量变化的临床意义

目的 观察N端脑钠肽前体(NT-pro-brain natriuretic peptide,NT-proBNP)及心肌肌钙蛋白I(cardiac tropomin I,CTnI)在小儿不完全川崎病中的变化,探讨其在不完全川崎病诊断中的价值.方法 选取2008年8月至2010年9月在顺德区儿童医院儿科住院的40例典型川崎病(TKD)和28例不完全川崎病(IKD)患儿,分别检测其急性期及恢复期血液NT-proBNP及CTnI,同时选取30名同期在儿科住院伴有发热的上呼吸道感染患儿作为对照组.对川崎病患儿急性期行心脏彩超检查,并对并发冠状动脉病变(CAL)与无冠状动脉病变(NCAL)两组川崎病患儿NT-proBNP、CTnI早期含量进行回顾分析与比较.结果 TKD组和IKD组急性期血液NT-proBNP分别为(426±25)pg/ml、(435±136)pg/ml,CTnI含量分别为(0.66±0.13)ng/ml、(0.68±0.17)ng/ml,两组差异无统计学意义(P＞0.05);KD组急性期血液NT-proBNP为(430±123)pg/ml、CTnI为(0.67±0.12)ng/ml,明显高于恢复期NT-proBNP(118±82)pg/ml、CTnI(0.23±0.08)ng/ml]和对照组NT-proBNP(40±25)pg/nl、CTnI(0.06±0.04)ng/ml],差异有统计学意义(P＜0.01);IKD组合并冠脉病变占50%(14/28),显著高于TKD组合并冠脉病变的25%(10/40,P＜0.01);并发冠状动脉病变的川崎病患儿早期NT-proBNP(478+130)pg/ml、CTnI(0.91±0.24)ng/m1]明显高于无冠状动脉病变的川崎病患儿的NTproBNP(382+110)pg/ml、CTnI(0.51±0.13)ng/ml],两者差异有统计学意义(P＜0.01).结论 血液NT-proBNP及CTnI在川崎病患儿急性期有明显变化,并且有一定的特异性,有助于IKD患儿急性期的早期诊断.

The clinical significance of the change of NT-proBNP and CTnI in children with incomplete Kawasaki disease

Objective To explore the change of NT-proBNP and CTnI in children with incomplete Kawasaki disease and study the value in the diagnosis of incomplete Kawasaki disease.Methods NT-proBNP and CTnI were detected in 40 cases of typical Kawasaki disease(TKD) and 28 cases of incomplete Kawasaki disease(IKD) and 30 cases of respiratory tract infection in our hospital from Aug.2008 to Sep.2010.Meanwhile,ultrasound cardiogram examination was made in Kawasaki disease.Results There was no statistical significant differ...