川崎病患儿血浆脑利钠肽水平改变及其与心功能的关系

Levels of serum brain natriuretic peptide and the correlation to heart function in children with Kawasaki disease

目的探讨脑利钠肽(BNP)在川崎病(KD)患儿血浆中的变化及其与心功能的关系。方法选择KD患儿43例作为观察组(KD组),30例健康儿童作为对照组。对KD急性期、恢复期患儿及对照组儿童采用酶联免疫吸附法测定血浆BNP浓度,KD组常规超声心动图检测左室射血分数(LVEF)、左室短轴缩短率(LVSF)、心脏指数(CI)及舒张期二尖瓣血流频谱速度(E/A)。结果KD患儿急性期血浆BNP水平明显高于恢复期及对照组,差异有统计学意义(P<0.01)。急性期LVEF、LVSF、CI较恢复期降低,差异有统计学意义(P<0.05)。直线相关分析显示,KD患儿急性期血浆BNP水平与LVEF、LVSF、CI均呈负相关(r=-0.63,-0.52,-0.53,P<0.05)。结论血浆BNP浓度在KD急性期异常升高,与左室收缩功能呈负相关。血浆BNP水平检测对KD的早期诊断具有重要意义。

Objective To study serum levels of brain natriuretic peptide （BNP） in children with Kawasaki disease （KD） and the correlation between BNP levels and the heart function.Methods Forty-three children with KD and thirty healthy children were enrolled. Serum levels of BNP were measured using ELISA. KD children received an echocardiographic examination, including measurements of left ventricular ejection fraction （LVEF）, left ventricular shorten fraction （LVSF）, cardiac index （CI） and left ventricular inflow velocity through the mitral annulus.Results Mean serum level of BNP at the acute stage in children with KD was significantly higher than that at the recovery stage as well as the control group （P0.01）. The LVEF, LVSF and CI levels at the acute stage were significantly lower than those at the recovery stage in children with KD （P0.05）. The linear regression analysis showed that the BNP level was negatively correlated with the levels of LVEF, LVSF and CI （r=-0.63, -0.52, -0.53, P0.05）.Conclusions The serum BNP levels increase significantly in KD children at the acute stage, and are negatively correlated with the levels of LVEF, LVSF and CI. Measurement of serum BNP level is useful for the early diagnosis of KD.