支气管肺炎患儿血清脑钠肽水平与心功能的相关性

Correlation between Serum Brain Natriuretlc Peptide and Cardiac Function in Children with Pneumonia

目的探讨支气管肺炎患儿心功能状态与血清脑钠肽(BNP)水平的相关性。方法选取支气管肺炎患儿52例。其中并心力衰竭(心衰)患儿20例。男9例,女11例;年龄4个月～4岁。未并心衰患儿32例。男17例,女15例;年龄6个月～5岁。健康对照组婴幼儿30例。男16例,女14例;年龄6个月～5岁。3组儿童均抽取静脉血离心后留取血清,采用ELISA法测定其血清BNP水平,采用全自动生化分析仪测定其CK-MB水平,同时应用心脏超声诊断仪测定及计算心功能指标。结果支气管肺炎并心衰患儿血清BNP水平[(182.45±57.32)ng/L]、CK-MB水平[(48.19±16.08)IU/L],均高于健康对照组[(35.12±13.84)ng/L、(11.48±4.29)IU/L](Pa<0.01),支气管肺炎未并心衰患儿血清BNP及CK-MB水平分别为(43.69±19.55)ng/L、(13.06±5.64)IU/L,与健康对照组比较,均无显著性差异(Pa>0.05)。支气管肺炎并心衰患儿左心室射血分数(LVEF)、左室小轴缩短率(FS)、主动脉峰值流速(PFVA)及肺动脉峰值流速(PFVP)均较健康对照组明显降低(Pa<0.01),支气管肺炎未并心衰患儿与健康对照组比较,均无显著性差异(Pa>0.05)。血清BNP水平与CK-MB水平呈正相关(r=0.28 P<0.05),与LVEF、FS、PFVA、PFVP均呈负相关(r=-0.65,-0.58,-0.32 Pa<0.01;r=-0.39 P<0.05)。血清CK-MB与LVEF、FS均呈负相关(r=-0.30,-0.26Pa<0.05),与PFVA、PFVP均无相关性(Pa>0.05)。结论血清BNP水平可作为支气管肺炎患儿并心衰的实验室指标。

Objective To explore the correlation between serum brain natriuredc peptide （BNP） and cardiac function in children with pneumonia. Methods Fifty - two children with pneumonia were seleated. Among them 20 were complicated with congestive heart failure （CHF） ,including 9 boys and 11 girls, their ages ranging from 4 months to 4 years old; and 32 cases non - complicated with CHF, including 17 boys and 15 girls, their ages ranging from 5 months to 6 years old. Besides, there were 30 healthy children as control group, including 16 boys and 14 girls, their ages ranging from 6 months to 5 years old. For all the children, their serum BNP was measured by using ELISA method, and CK- MB was measured by automatic biochemistry analyzer. In the sametime, their cardial function was measured by eehocardiography. Results In the children with pneumonina complicated with CHF,the levels of serum BNP[ （ 182.45 ± 57.32） ng/L] and CK - MB [（48.19 ±16.08） IU/L] were higher than those of healthy control group[ （35.12 ±13.84） ng/L,（11.48 ±4.29） IU/L Pa 〈0.01]. There was no statistically significant difference in serum levels of BNP[ （43.69 ± 19.55 ） ng/L ] and CK - MB [ （ 13.06 ± 5.64 ） ng/L ] between the children with pneumonina non -complicated with CHF and healthy control group（ Pa 〉 0.05 ）. The levels of left ventricular ejection fraction（LVEF） ,left ventricle shortening fraction （FS）, peak flow velocity of arteriae arota （PFVA）, peak flow velocity of pulmonary artery （PFVP） in the children with pneumonia complicated with CHF were lower than those of healthy control group（Pa 〈0. 01 ）. But there was no statistically significant difference in serum levels between the children with infant pneumonia uncomplicated with CHF and healthy control group（ Pa 〉0O. 05 ）. There was a positive correlation between the levels of serum BNP and CK - MB （ r = 0.28 P 〈 0.05 ）, and the levels of serum BNP indicated negative correlation with LVEF, FS,PFVA and PFVP （r= -0.65, -0.58, -0.32, -0.39 P 〈0.01,0.01,0.01, 0.05） in children with pneumonia. There was a negative correlation between the levels of serum CK - MB and LVEF,FS （r = -0. 30, - 0.26 Pa 〈 0.05 ）, and non - correlation between CK - MB and PFVA, PFVP （ Pa 〉 0. 05 ）. Conclusion The levels of serum BNP may be an important index in diagnosis of infant pneumonia complicated with CHF.