N端脑钠肽前体对新生儿心力衰竭的早期诊断价值

Early Diagnostic Value of N-Terminal Pro-B-Type Natriuretic Peptide for Heart Failure in Neonates

目的检测血浆N端脑钠肽前体(NT-proBNP)在高危新生儿心力衰竭(HF)的表达水平,探讨NT-proBNP对新生儿HF的早期诊断价值。方法收集窒息后HF新生儿35例(HF组)及同期无窒息、无HF新生儿20例(对照组)。于出生第2天、第7天用电化学发光法检测血浆NT-proBNP水平,质量法检测CK-MB水平,采用SPSS16.0软件进行统计学分析。结果与对照组比较,治疗前HF组NT-proBNP、CK-MB水平均高于对照组,差异有统计学意义(P<0.05,0.01);治疗后CK-MB水平仍显著高于对照组(P<0.05),而NT-proBNP水平与对照组比较差异无统计学意义(P>0.05)。与治疗前比较,HF组治疗后NT-proBNP、CK-MB水平均显著降低,差异有统计学意义(P<0.05,0.001);治疗前后对照组CK-MB水平差异无统计学意义(P>0.05),NT-proBNP水平显著降低(P<0.01)。结论联合检测NT-proBNP、CK-MB水平可动态观察心肌损害程度及HF恢复情况,NT-proBNP检测可作为临床早期诊断新生儿HF的指标之一。

Objective To explore the early diagnostic value of the expression level of plasma N-terminal pro-B-type natriuretic peptide（NT-proBNP）for heart failure（HF）in neonates.Methods Thirty-five neonates who were clinic diagnoses as HF newborns and 20 cases of non-HF newborns（control group）were selected,on the 2^nd,the 7^th day after birth,plasma NT-proBNP and CK-MB levels were measured with electrochemiluminescence method and mass method.All data were analyzed by SPSS 16.0 software.Results Compared with the control group,CK-MB and NT-proBNP were higher in the HF group before treatment（P〈0.05,0.01）,CK-MB level was still higher than the control group after treatment（P〈0.05）,NT-proBNP level had not statistically difference after treatment（P〉0.05）.Compared with before treatment,CK-MB and NT-proBNP were significantly lower in the HF group（P〈0.05,0.001）,and CK-MB level had not statistically significant difference in the control group（P〉0.05）,NT-proBNP level was lower in the control group（P〈0.01）.Conclusions The joint detection of CK-MB and NT-proBNP level may dynamicly observe myocardial damage and HF recovery,while the NT-proBNP testing provide a reliable indicator for early diagnosis of neonatal HF.