磷酸肌酸钠对肺炎心衰患儿血浆BNP水平的影响及意义

目的探讨磷酸肌酸钠（CP）在小儿心力衰竭（心衰）治疗中的应用价值以及血浆脑钠肽（BNP）的变化对心衰患儿预后的指导意义。方法研究对象为87例心衰患儿,入院后24 h内评估心脏功能并抽取静脉血检测血浆BNP。其中肺炎心衰44例,先天性心脏病（先心病）合并肺炎心衰43例。将其随机分为CP组44例和1,6二磷酸果糖组（FDP组）43例;在镇静、吸氧、抗感染、强心、利尿等常规治疗的基础上分别予CP和FDP治疗7 d。检测治疗前后血浆BNP水平,心脏超声检查测定心功能指标左室射血分数（EF）、左室短轴缩短率（FS）;治疗72 h判定疗效。结果 CP组有效率明显高于FDP组（P〈0.05）;两组BNP、EF、FS均有改善,但CP组较FDP组改善明显（P〈0.01或P〈0.05）。结论 BNP水平与心衰患儿的预后有关,CP对改善心脏功能有明显疗效。

Effects of creatine phosphate on the level of plasma BNP in infants with pneumonia combining heart failure and its significance

Objectives To investigate the application value of creatinephosphate（CP） in the treatment of pediatric heart failure and the prognosis guiding significance of plasma brain natriuretic peptide（BNP） variation.Methods Total of 87 infants（44 cases of common pneumonia combining heart failure infants,43 cases of CHD and pneumonia combining heart failure infants with heart failure）were enrolled,then were randomly divided into CP group with 44 cases and FDP group with 43 cases,then were given CP and FDP respectively for 7 d,on the basis of routine treatment including tranquilizing,oxygen uptake,anti-infection,cardiacdiuretic.Before and after the treatment,variation of plasma BNP and cardiac EF,FS value were detected;the effectiveness after 72 h was estimated.Results The effective rate of CP group was significantly higher than that of FDP group（P0.05）;the BNP,EF,FS of both groups were improved,but those of CP group were better（P0.01 or P0.05）.Conclusions BNP levels are related with the prognosis of heart failure infants,CP can improve cardiac function significantly.