肺炎合并心衰患儿血清脂肪酸结合蛋白与脑利钠肽的水平改变

目的：通过观察肺炎并心衰患儿血清脂肪酸结合蛋白(fatty acid-binding protein,FABP) 水平变化,并与脑利钠肽（brain natriuretic peptide，BNP）进行对比分析,探讨其在肺炎合并心衰患儿中的临床价值。方法：选择肺炎并心衰患儿36例为研究对象， 28例健康儿童为对照组,采用酶联免疫吸附试验进行定量检测FABP，BNP。结果：心衰期血清FABP，BNP水平均显著高于恢复期及对照组( 均P<0.01)，恢复期FABP，BNP水平亦显著高于对照组(均P<0.01)；心衰期、恢复期血清FABP的阳性率显著高于BNP升高的阳性率（均P<0.05）。结论：FABP，BNP血清浓度均可作为肺炎合并心衰患儿早期心肌损害的生化标志物，而FABP具有更高的灵敏度。恢复期患儿也有较高的FABP，BNP血浆浓度，提示临床症状好转但心肌损害仍可持续较长时间。

Serum levels of fatty acid-binding protein and brain natriuretic peptide in children with pneumonia complicated by acute congestive heart failure

Objective To assess the values of serum fatty acid-binding protein(FABP)and brain natriuretic peptide(BNP)in pneumonia complicated by acute congestive heart failure(CHF)in children.Methods Serum levels of FABP and BNP were determined using ELISA in 36 children with pneumonia complicated by CHF(pneumonia group)and 28 healthy children(control group).Results Serum levels of FABP and BNP in the pneumonia group at the acute stage were significantly higher than those in the control group and those at the recovery stage(P<0.01).Compared with the control group,serum levels of FABP and BNP in the pneumonia group at the recovery stage increased significantly(P<0.01).At the acute stage,35 patients(97.2%)showed increased serum FABP level but 28(77.8%)showed increased serum BNP level(P<0.05)in the pneumonia group.At the recovery stage,the incidence of abnormal serum FABP(72.2%)was significantly higher than that of BNP(44.4%)in the pneumonia group(P<0.05).Conclusions Serum levels of FABP and BNP can be regarded as biochemical markers of myocardial damage in children with pneumonia complicated by CHF and serum FABP appears to be a more sensitive one.Serum FABP and BNP remained at higher levels through the recovery stage,suggesting that myocardial damage existed though the clinical symptoms were improved at the stage.