小儿血清脑钠肽与心功能的关系及心力衰竭诊断阈值判断

The relationship between serum brain natriuretic peptide and cardiac function and the diagnostic threshold value of heart failure in children

目的研究血清脑钠肽(BNP)与心功能的关系及BNP作为心力衰竭(心衰)诊断的阈值。方法对比41例健康儿童及51例心衰患儿的血清BNP;对比28例右心衰竭和23例左心衰竭患儿BNP;分析左心衰竭患儿BNP与EF、主动脉峰值流速的关系及右心衰竭患儿BNP与肺动脉峰值流速的关系。根据健康儿童和心衰患儿BNP水平,制订心衰患儿的BNP诊断阈值。结果51例心衰患儿BNP为(625.30±125.28)ng/L,显著高于健康儿童(51.32±6.20)ng/L;左心衰竭患儿BNP为(671.30±90.56)ng/L,右心衰竭患儿为(587.51±98.27)ng/L,二者差异无显著性;BNP水平与心功能呈显著负相关;以健康儿童BNP的均数加3倍标准差(-x+3s)作为健康儿童的99%上限,则>70ng/L为诊断心衰阈值,其敏感性为96.1%,特异性为87.8%。结论心衰患儿BNP显著升高,BNP与心功能呈显著负相关;左心衰竭与右心衰竭之间BNP水平无显著差异;BNP诊断心衰的阈值为>70ng/L。

Objective To analyse the relationship between serum BNP and heart function and the heart failure diagnostic threshold value of BNP in children. Methods The BNP was measured in 41 normal children and 51 cases with heart failure. The relationship between serum BNP and heart function were calculated. The heart failure diagnostic threshold value was determined according to BNP of normal children and children with heart failure. Results The BNP value of children with heart failure was（625.30± 125.28） ng/ L, which was higher than that of normal children[ （51.32± 6.20） ng/L]. The BNP level was no significantly different between the children with left heart failure and the right heart failure. The BNP was negatively related to the cardiac function. The mean value plus 3 s of BNP was set as the upper limit of normal children. Heart failure diagnostic threshold value of BNP was 〉 70 ng/L. The sensitivity was 96.1%. The reliability was 87.8 %. Conclusion The BNP of children with heart failure was elevated and was negative related to heart function. The heart failure diagnostic threshold value of BNP was 〉70 ng/L.