婴幼儿肺炎并发心力衰竭IMA、BNP、NT-proBNP的变化及意义

Changes and significance of IMA,BNP,and NT-proBNP in infants with pneumonia complicated with heart failure

目的 探讨婴幼儿肺炎并发心力衰竭(Heart failure,HF)血清缺血修饰白蛋白(Ischemia-modified albumin,IMA)、脑钠肽(Brain natriuretic peptide,BNP)及N-末端前体脑钠肽(N-terminal precursor brain natriuretic peptide,NT-proBNP)表达特征及检测意义。方法 选取2019年10月至2021年3月间我院肺炎并发HF婴幼儿37例设为研究组、单纯肺炎婴幼儿37例设为对照组,另选取同期健康婴幼儿37例设为健康组;抽取所有受检者血液样本,测定IMA、BNP、NT-proBNP含量,并经超声检查测定左心室射血分数(Left ventricular ejection fraction,LVEF);统计三组及研究组婴幼儿不同时期BNP、NT-proBNP、IMA及LVEF水平,并分析BNP、NT-proBNP、IMA水平与LVEF水平间关联性。结果 对照组BNP、NT-proBNP、IMA水平高于健康组,LVEF水平低于健康组(均P<0.05);研究组BNP、NT-proBNP、IMA水平高于对照组,LVEF水平低于对照组(均P<0.05);研究组恢复期BNP、NT-proBNP、IMA水平低于急性期,LVEF高于急性期(均P<0.05);研究组急性期、恢复期BNP、NT-proBNP、IMA水平与LVEF间存在显著负相关关系(P<0.05)。结论 婴幼儿肺炎并发HF者BNP、NT-proBNP、IMA水平异常增高,LVEF显著降低,且疾病急性期与恢复期各指标水平间存在明显差异,各生化指标水平与LVEF间呈负相关关系,可通过测定上述指标水平评估婴幼儿病情。

Objective To investigate expression and significance of the serum ischemia-modified albumin(IMA), brain natriuretic peptide(BNP) and N-terminal precursor brain natriuretic peptide(NT-proBNP) in infants with pneumonia complicated with heart failure(HF). Methods From October 2019 to March 2021, 37 children with pneumonia complicated with HF in our hospital were selected as the research group, 37 children with simple pneumonia were selected as the control group, and 37 healthy infants and young children during the same period were selected as the healthy group. Blood samples were drawn from all subjects to determine the contents of IMA, BNP and NT-proBNP, and the left ventricular ejection fraction(LVEF) was determined by ultrasonography. The levels of BNP, NT-proBNP, IMA and LVEF in the three groups and the study group at different periods were counted, and the correlation between the levels of BNP, NT-proBNP, IMA and LVEF was analyzed.Results The levels of BNP, NT-proBNP and IMA in the control group were higher than those in the healthy group, and the levels of LVEF were lower than those in the healthy group(all P<0.05). The levels of BNP, NT-proBNP and IMA in the study group were higher than those in the control group, and the levels of LVEF were lower than those in the control group group(all P<0.05). The levels of BNP, NT-proBNP and IMA in the study group were lower than those in the acute stage, and the LVEF was higher than that in the acute stage(all P<0.05). The levels of BNP, NT-proBNP, and IMA in acute stage and recovery stage had a significant negative correlation with the level of LVEF(P<0.05). Conclusion The levels of BNP, NT-proBNP, and IMA in infants with pneumonia complicated with HF are abnormally increased, and the LVEF is significantly decreased, and there are significant differences between the levels of each index in the acute stage and the recovery stage of the disease, and the levels of each biochemical index are negatively correlated with LVEF. The condition of children can be assessed by measuring the levels of the above indicators.