脑钠素与肌钙蛋白I在小儿心力衰竭诊断、预后评估中的意义

目的 探讨血浆脑钠素(BNP)、肌钙蛋白I(CTnI)水平变化在小儿心力衰竭(CHF)患儿诊断、预后评估中的意义.方法 选择心力衰竭患儿41例,根据ROSS心功能分期将CHF患儿分为心衰早期、心衰期、恢复期.41例健康体检者作为对照组.分别采用放射免疫分析法和化学发光免疫分析法检测各组血浆BNP及CTnI水平;同时观察血浆BNP水平与CHF患儿预后的关系.结果 心衰早期患儿血浆BNP、CTnI即开始升高,心衰期达高峰,恢复期逐渐下降,但仍显著高于正常对照组(P＜0.01).心衰早期、恢复期患儿血浆BNP阳性率(92.7%,90.2%)较CTnI阳性率(63.4%,58.5%)有显著性差异(P＜0.01);BNP持续＞500 ng/L的心脏事件发生率(66.7%)明显高于BNP＜500 ng/L的心脏事件发生率(21.4%)(P＜0.01).结论 BNP、CTnI可反映心肌损伤程度;血浆BNP在心衰早期诊断方面其敏感性及特异性均优于CTnI,血浆BNP可作为诊断和判定小儿心衰预后的重要参考依据之一.     

心力衰竭患儿脑钠素与肌钙蛋白I的临床意义

目的探讨血浆脑钠素(BNP)、肌钙蛋白I(cTnI)质量浓度的变化在心力衰竭(简称心衰,CHF)患儿的临床诊断、预后评估中的意义。 方法2003-02—2005-02于青岛市海慈医院住院诊断心衰的患儿41例,同时选健康体检者41例作为正常对照组,采用放射免疫分析法分别检测其 血BNP及cTnI的水平。 结果心衰早期BNP、cTnI即开始升高,心衰期达高峰,恢复期逐渐下降,但仍高于正常对照组(P<0.01);心衰早期、恢复期BNP阳性率(92.7%, 90.2%)较cTnI阳性率(63.4%,58.5%)差异有显著性(P<0.01);BNP持续高于500ng/L的心脏事件发生率(66.7%)较BNP<500ng/L的心脏事件发生率 (21.4%)高,差异有显著性(P<0.01)。 结论心衰患儿血浆BNP、cTnI质量浓度明显升高,BNP、cTnI可反映其心肌损伤;血浆BNP在心衰早期诊断方面,其敏感性及特异性均优于cTnI, 可作为诊断小儿心衰的一项重要指标;血浆BNP则可作为判断预后的一个重要参考依据。     

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目的 探讨血浆脑钠素(BNP)、肌钙蛋白Ⅰ(cTnI)质量浓度的变化在心力衰竭(简称心衰,CHF)患儿的临床诊断、预后评估中的意义.方法 2003-02-2005-02于青岛市海慈医院住院诊断心衰的患儿41例,同时选健康体检者41例作为正常对照组,采用放射免疫分析法分别检测其血BNP及cTnI的水平.结果 心衰早期BNP、cTnI即开始升高,心衰期达高峰,恢复期逐渐下降,但仍高于正常对照组(P＜0.01);心衰早期、恢复期BNP阳性率(92.7%,90.2%)较cTnI阳性率(63.4%,58.5%)差异有显著性(P＜0.01);BNP持续高于500 ng/L的心脏事件发生率(66.7%)较BNP＜500 ng/L的心脏事件发生率(21.4%)高,差异有显著性(P＜0.01).结论 心衰患儿血浆BNP、cTnI质量浓度明显升高,BNP、cTnI可反映其心肌损伤;血浆BNP在心衰早期诊断方面,其敏感性及特异性均优于cTnI,可作为诊断小儿心衰的一项重要指标;血浆BNP则可作为判断预后的一个重要参考依据.     

血浆脑钠肽测定在婴儿心衰中的应用

目的探讨血浆脑钠肽（BNP）与婴儿心力衰竭（简称心衰）严重程度的关系。方法35例心衰婴儿根据Ross评分分成轻、中、重3组，30名健康婴儿作为对照组，测定他们的射血分数（EF）和血浆BNP。结果心衰组婴儿血浆BNP水平显著高于对照组（P〈0．01），并随心衰严重程度升高而升高（r=0．86，P〈0．01），与EF成负相关（r=-0．79，P〈0．01）。心衰纠正后血浆BNP下降，显著低于心衰纠正前水平（P〈0．01）。．结论血浆BNP水平是有助于婴儿心衰诊断、严重程度提示和预后判断的一个可靠指标。     

小儿血清脑钠肽与心功能的关系及心力衰竭诊断阈值判断

目的研究血清脑钠肽（BNP）与心功能的关系及BNP作为心力衰竭（心衰）诊断的阈值。方法对比41例健康儿童及51例心衰患儿的血清BNP；对比28例右心衰竭和23例左心衰竭患儿BNP；分析左心衰竭患儿BNP与EF、主动脉峰值流速的关系及右心衰竭患儿BNP与肺动脉峰值流速的关系。根据健康儿童和心衰患儿BNP水平，制订心衰患儿的BNP诊断阈值。结果51例心衰患儿BNP为（625．30±125．28）ng／L，显著高于健康儿童（51．32±6．20）ng／L；左心衰竭患儿BNP为（671．30±90．56）ng／L，右心衰竭患儿为（587．51±98．27）ng／L，二者差异无显著性；BNP水平与心功能呈显著负相关；以健康儿童BNP的均数加3倍标准差（三＋3s）作为健康儿童的99％上限，则〉70ng／乙为诊断心衰阈值。其敏感性为96．1％，特异性为87．8％。结论心衰患儿BNP显著升高，BNP与心功能呈显著负相关；左心衰竭与右心衰竭之间BNP水平无显著差异；BNP诊断心衰的阙值为〉70ng／L。     

血浆D-乳酸对小儿胃肠功能障碍评价的研究

目的探讨小儿危重症血浆D-乳酸的变化规律，评价D-乳酸对小儿危重症胃肠功能障碍的诊断价值。方法检测不同危重程度，胃肠功能障碍或衰竭时血浆D-乳酸的水平以及动态监测小儿危重症急性期和恢复期D-乳酸的变化。结果随着危重程度增加，血浆D-乳酸显著上升，不同危重程度组血浆D-乳酸水平相比差异有统计学意义（P〈0．01）；胃肠功能障碍或衰竭时患儿血浆D-乳酸水平与正常对照组及非胃肠功能障碍组比较差异有显著性（P〈0．01）；危重组及极危重组患儿恢复期血浆D-乳酸水平较急性期明显下降，差异有统计学意义（P〈0．01，P〈0．01）。结论血浆D-乳酸可作为小儿危重症胃肠功能障碍或衰竭的诊断指标以及胃肠功能恢复的指标。     

川崎病患儿血清脑利钠肽的水平改变及其与肌钙蛋白的对比分析

目的通过观察到川崎病（KD）患儿脑利钠肽（BNP）的水平变化,并与肌钙蛋白Ⅰ（cTnⅠ）比较,探讨其在KD早期诊断中的作用。方法选择住院KD患儿2l例作为研究对象,20例健康体检儿童作为对照组。对KD组及对照组采用酶联免疫吸附法测定血浆BNP、cTnI浓度,并行心脏多普勒超声检查测定冠状动脉内径。结果KD患儿血浆BNP水平[（517．26±213．40）μg／L]明显高于对照组[（37．55±7．56）μg／L],差异有非常显著性（P〈0．01）;cTnI浓度[（0．31±0．17）μg／L]也高于对照组[（0．13±0．04）μg／L],差异有显著性（P〈0．01）。KD患儿BNP异常率（100％）明显高于cTnI（47．7％）,差异有非常显著性（P〈0．01）;冠状动脉病变组血浆BNP、cTnI水平明显高于非冠状动脉病变组;典型KD患儿及不完全型KD患儿BNP及cTnI血浆水平间差异无显著性（P〉0．05）。结论KD患儿血浆BNP、cTnI浓度均明显升高,而BNP具有更高的特异性及灵敏度。血浆BNP水平测定有助于KD的诊断,尤其是不完全型KD早期诊断。     

脂肪酸结合蛋白在小儿急性心力衰竭诊断中的应用研究

目的 通过测定急性充血性心力衰竭（CHF）患儿血浆脂肪酸结合蛋白（FABP）水平的变化，进一步探讨其在临床应用中的价值。方法 选择31例健康儿童作为对照组，CHF住院患儿48例作为观察组，其中肺炎合并CHF20例，先天性心脏病合并CHF18例，心肌炎合并CHF10例。FABP测定方法采用酶联免疫吸附法，比较CHF前后FABP水平；根据NYHA小儿CHF分级，对不同心功能级别患儿FABP水平间进行比较。结果 患儿CHF期FABP水平显著高于恢复期（P〈0．01）；同时CHF患儿心功能分级不同，FABP浓度明显不同，CHF程度越重，FABP浓度愈高，差异有非常显著性（P〈0．01）。结论 CHF时FABP浓度明显增高，FABP浓度与心功能密切相关；CHF程度越重，血FABP浓度越高。FABP可作为评价心功能程度及预后的指标。     

肌钙蛋白I、肌酸激酶同工酶对肺炎所致心力衰竭的诊断价值

目的 探讨血清心肌肌钙蛋白-Ⅰ（CTnⅠ）诊断肺炎心力衰竭（心衰）时心肌损害的临床价值。方法 检测肺炎心衰30例，轻症肺炎25例，健康儿童20例血清CTnI，肌酸激酶同功酶（CK-MB），对其临床诊断意义进行比较。结果 肺炎心衰组与健康儿童组、轻症肺炎组CTnⅠ与CK-MB阳性率、敏感性、特异性比较，均有显著性差异，P值均〈0．01。在诊断肺炎心衰患儿心肌损害上CTnⅠ优于CK-MB。结论 CTnⅠ与CK-MB对肺炎心衰患儿心肌损害有诊断价值，与CK-MB比较，CTnⅠ有较高特异性、灵敏度。     

血浆脑钠肽及心肌肌钙蛋白Ⅰ在小儿脓毒症诊断及评估中的意义

目的探讨血浆脑钠肽（BNP）及心肌肌钙蛋白I（cTnI）测定在小儿脓毒症诊断及评估中的意义。方法应用化学发光法检测47例脓毒症患儿和50例一般感染患儿入院时血浆BNP及cTnI的浓度,并选取同期入院的11例非感染患儿为对照组。结果（1）脓毒症组血浆BNP水平（ng／L）[中位数（四分位数间距）]为164．40（308．60）,高于一般感染组[50．35（63．97）]及对照组[28．90（12．28）],差异有非常显著性（P〈0．01）。严重脓毒症组血浆BNP水平（ng／L）[379．88（1108．70）]高于一般脓毒症组[135．30（211．88）],差异有显著性（P〈0．05）。（2）脓毒症组血浆eTnI水平（μg/L）[中位数（四分位数间距）]为0．05（0．07）,高于一般感染组[0．03（0．03）]及对照组[0．03（0．04）],差异有显著性（P〈0．05）。严重脓毒症组血浆cTnI水平（μg／L）[0．10（0．20）]高于一般脓毒症组[0．04（0．03）],差异有非常显著性（P〈0．01）。结论脓毒症患儿在除外充血性心力衰竭因素时,血浆BNP及cTnI水平有助于临床医生对脓毒症进行诊断和严重程度评估。     

Normal and abnormal height and weight development in children and adolescents in Krakow--changes and trends in the last thirty years

The aim of this study is to determine the frequency of height and weight disharmony in children and adolescents in Krakow, i.e. both overweight and underweight in relation to height and the trends in last thirty years. MATERIALS AND METHODS: 4532 individuals -- a random sample of children and adolescents (2416 boys and 2107 girls) were examined in 2000. The results of the examination were compared with data obtain in 1971 (random sample of 4090 individuals) and with results from 1983 (random sample of 6536 individuals). Percentile position of height and weight were compared: the difference of two or more percentiles channels classified the results as overweight or underweight depending on height. THE RESULTS: Of the research prove that the frequency of occurrence of dis-harmonious body built increases with age, both with regard to overweight and underweight related to height and this phenomenon is more frequent in girls. In last thirty years a progressive increase of frequency of overweight was observed, but in girls it was noticeable and statistically significant only in 1971 -- 1983.     

Trends in perinatal and neonatal mortality and morbidity in India

Although the infant mortality rate (IMR) has reduced by 50% during the past century, it compares poorly with the advanced countries and some developing countries. The observed fall in IMR has been mostly in post-neonatal mortality, with the result that neonatal deaths now account for over 60% of all infant deaths. The overall perinatal mortality rate (PMR) in India is still over 50 per 1000 and has shown virtually no decline during the past decade, However, PMR differs widely in different states, urban/rural areas, different hospitals and so on. PMR is seen to correlate better with social development than economic development of the representative community. The causes of perinatal deaths suggest poor health of mother and poor health facilities and are hence potentially preventable. Various studies have shown that PMR can be significantly reduced within a short span of time. The registration of vital statistics continue to be highly unsatisfactory especially in rural areas.     

Bacteriuria in Pregnancy and Infection in Amniotic Fluid and Infant

Women with asymptomatic bacteriuria during pregnancy had sterile amniotic fluid at the time of delivery.There was no evidence that maternal urinary infection was associated with infection in the infant.     

Prevalence of overweight and obesity in children and adolescents in a county in Sweden

Overweight among young people in Sweden is increasing. The aim of the present study was to investigate the frequency of overweight and obesity based on body mass index (BMI) values among children and adolescents. Overweight was defined as a BMI value > or = 91st percentile and obesity as a BMI value > 98th percentile on an international reference BMI curve. The study population included boys and girls from four age groups: 9, 12, 15 and 18 y. The data consisted of self-reported measures of height and weight that were obtained from questionnaires used in a cross-sectional study in December 1997. A validation study was performed using a part of the study population. A total of 7011 (81.7%) participants completed the questionnaire. The correlation between self-reported estimations and objective measures of height and weight was high in the oldest age groups (0.88-0.98), but lower in the 9-y-old age groups (0.37-0.72). These self-reported estimations in the 9-y-olds were excluded from further analysis. It was found that 12.3%, 11.6% and 11.4% of the boys in the 12-, 15- and 18-y-old age groups and 6.8%, 5.5% and 4.8% of the girls in the same age groups were overweight and 7.9%, 8.9% and 7.3% of the boys and 5.1%, 4.2% and 3.9% of the girls were obese. Conclusion: The prevalence of overweight and obesity was found to be high in the study population and is a serious public health problem. The prevalence of obesity was significantly higher (p < 0.05) in 15-y-old boys living in rural areas than in city and town dwellers of the same age.