血浆脑利钠肽对扩张性心肌病患儿病情的评估

Evaluation of Brain Natriuretic Peptide in Children with Dilated Cardiomyopathy

目的探讨脑利钠肽(BNP)与扩张性心肌病患儿病情严重程度的相关性。方法扩张性心肌病患儿30例为研究组,选择健康儿童30例为对照组。两组均测定血浆BNP水平。进行t检验,比较各组血浆BNP水平,采用直线相关分析法分析BNP值与左室射血分数和心功能分级关系。结果扩张性心肌病患儿血浆BNP水平明显高于对照组[(429.4±270.2)ng/Lvs(67.0±10.2)ng/L];扩张性心肌病患儿血浆BNP水平与心功能分级呈正相关(r=0.950P<0.01),与左心室射血分数呈负相关(r=-0.695P<0.001),与左心室舒张末期内径无明显相关性(r=0.030P>0.1)。受试者工作特征曲线(ROC)曲线下面积为0.550,以血浆BNP水平95ng/L为判定心衰界值时,具有较高的灵敏度、特异度。结论血浆BNP可作为迅速评估扩张性心肌病患儿病情的依据之一。

Objective To determine the correlation of plasma brain natriurefic poptide（BNP） with severe degree of dilated cardiomyopathy in children. Methods Thirty children with dilated eardiomyopathy and 30 healthy subjects were selected in this degree of study, plasma BNP concentration was measured and compared among groups by using t test. Correlation of BNP levels with left ventrieular ejection fraction and heart function was investigated using linear regression analysis. Results Children with dilated eardiomyopathy had significantly higher mean BNP levels compared with healthy children [ （429.4±270.2） ng/L vs （ 67.0 ±10.2 ） ng/L ]. Significantly positive correlations were found between BNP and heart classification（ r = 0. 950 P 〈 0.01 ）. Children with congestive heart failure （CHF） caused by dilated eardiomyopathy had a negative correlation between BNP and ejection fraction（ r = - 0. 695 P 〈 0. 001 ）, had no obviously correlation between BNP and left ventrieular and diastolic dimension. The received operating characteristic （ROC） area under the curve was 0. 550 ; when the blood plasma BNP level reached 95 ng/L was taken as the threshold value of judgment of heart failure. Its sensitivity and specificity were higher. Conclusion BNP may provide a useful tool in the assessment of symptomatic state in children with dilated eardiomyopathy.