肺炎合并心力衰竭患儿血清N-BNP、sST2水平变化及其与心功能的相关性分析

目的探讨肺炎合并心力衰竭患儿血清氨基末端脑钠肽(N-BNP)、可溶性人基质裂解素(sST2)水平变化及其与心功能的相关性。方法回顾性选取2016年8月至2020年5月辽阳市中心医院收治80例肺炎合并心力衰竭患儿作为疾病组;根据ROSS评分法将疾病组患儿分为轻度(n=27)、中度(n=31)、重度(n=22)心力衰竭组;根据美国纽约心脏病学会(NYHA)心功能分级标准,将疾病组患儿分为心功能Ⅱ级(n=21)、Ⅲ级(n=35)、Ⅳ级(n=24)组。并选取同期在辽阳市中心医院进行的体检健康儿童80例作为对照组。观察疾病组与对照组,轻度、中度、重度心力衰竭组,心功能Ⅱ级、Ⅲ级、Ⅳ级组的血清N-BNP、sST2的变化。分析患儿血清N-BNP、sST2与心功能分级的相关性。结果疾病组血清N-BNP、sST2水平分别为(1209.98±347.72)pg/mL、(1.14±0.71)ng/mL均高于正常组(284.46±42.76)pg/mL、(0.28±0.07)ng/mL],差异有统计学意义(P<0.05)。轻度、中度、重度心力衰竭组患儿血清N-BNP、sST2水平比较,差异均有统计学意义(P<0.05);其中,重度心力衰竭组患儿血清N-BNP、sST2水平分别为(1588.67±311.62)pg/mL、(1.34±0.53)ng/mL均高于轻度组(884.31±37.28)pg/mL、(0.86±0.06)ng/mL],中度组患儿血清N-BNP水平(1222.53±109.64)pg/mL]高于轻度组(884.31±37.28)pg/mL]。心功能Ⅱ、Ⅲ、Ⅳ级组患儿血清N-BNP、sST2水平比较,差异均有统计学意义(P<0.05);其中,心功能Ⅳ级组患儿血清N-BNP、sST2水平分别为(1532.34±208.66)pg/mL、(1.68±0.18)ng/mL,高于心功能Ⅱ(825.54±35.21)pg/mL、(0.62±0.08)ng/mL]、Ⅲ级组(1118.85±105.87)pg/mL、(1.09±0.13)ng/mL]。Spearman相关性分析结果显示,肺炎合并心力衰竭患儿心功能分级与血清N-BNP、sST2均呈正相关性(r=0.468、0.385,P=0.000、0.003)。结论肺炎合并心力衰竭患儿血清N-BNP、sST2水平高于健康儿童,两者水平与患儿心功能分级呈正相关,可为疾病的早期诊断、心功能评估提供理论依据。

Changes of serum N-BNP and sST2 levels and their correlation with cardiac function in children with pneumonia and heart failure

Objective To explore the changes in levels of serum N-terminal brain natriuretic peptide(N-BNP)and soluble suppression of tumorigenicity-2(sST2)and their correlation with cardiac function in children with pneumonia and heart failure(HF).Methods Eighty children with pneumonia and HF who were admitted to Liaoyang Central Hospital from August 2016 to May 2020 were enrolled as disease group.According to the ROSS score method,the children in the disease group were divided into mild(n=27),moderate(n=31),and severe(n=22)heart failure groups.According to the New York College of Cardiology(NYHA)cardiac function classification standards,children in the disease group were divided into cardiac function gradeⅡ(n=21),gradeⅢ(n=35),and gradeⅣ(n=24)groups.And 80 healthy children who underwent physical examination form Liaoyang Central Hospital during the same period were enrolled as control group.The levels of serum N-BNP and sST2 in the disease group and the control group,mild,moderate,and severe heart failure group,heart function gradeⅡ,Ⅲ,Ⅳgroup were observed.The correlation between serum N-BNP,sST2 and cardiac function was analyzed.Results The levels of serum N-BNP and sST2 in the disease group were(1209.98±347.72)pg/mL and(1.14±0.71)ng/mL,respectively,which were higher than those in normal group(284.46±42.76)pg/mL,(0.28±0.07)ng/mL],the differences were statistically significant(P<0.05).The differences in levels of serum N-BNP and sST2 were statistically significant among children with mild,moderate and severe heart failure(P<0.05).Among them,the serum N-BNP and sST2 levels of children in the severe heart failure group were(1588.67±311.62)pg/mL and(1.34±0.53)ng/mL,respectively,which were higher than those in the mild group(884.31±37.28)pg/mL,(0.86±0.06)ng/mL],the serum N-BNP level of children in the moderate group(1222.53±109.64)pg/mL was higher than that of the children in the mild group(884.31±37.28)pg/mL].The differences in levels of serum N-BNP and sST2 were statistically significant among children with cardiac function grading at gradeⅡ,Ⅲ,andⅣgroup(P<0.05).Among them,the levels of serum N-BNP and sST2 in children with heart function groupⅣwere(1532.34±208.66)pg/mL and(1.68±0.18)ng/mL,respectively,which were higher than those of heart functionⅡ(825.54±35.21)pg/mL,(0.62±0.08)ng/mL],grade III group(1118.85±105.87)pg/mL,(1.09±0.13)ng/mL].The results of Spearman correlation analysis showed that the cardiac function grades of children with pneumonia and HF were positively correlated with serum N-BNP and sST2(r=0.468,0.385,P=0.000,0.003).Conclusion The levels of serum N-BNP and sST2 in children with pneumonia and HF are higher than those in healthy children.The levels of the two are positively correlated with cardiac function grading,which can provide theoretical basis for early diagnosis of diseases and assessment of cardiac function.