肺炎并心力衰竭患儿血浆脑钠肽变化及其与心功能的关系

Changes of Plasma Brain Natriuretic Petide in Children with Pneumonia Complicated with Heart Failure and Their Relationship with Heart Function

目的探讨肺炎并心力衰竭患儿血浆脑钠肽（BNP）变化及其与心功能的关系。方法选取4年住院肺炎并心力衰竭患儿（肺炎心衰组）40例,男26例,女14例;年龄3个月-2岁。一般肺炎患儿（一般肺炎组）40例,男25例,女15例;年龄3个月-3岁。健康对照组为本院同期体检健康儿童共40例,男25例,女15例;年龄5个月-3岁。抽取各组患儿静脉血2-3 mL,采用酶联免疫吸附法（ELISA）测定血清BNP水平;同时均行心脏超声测定其左室射血分数（LVEF）和左室短轴缩短（LVFS）。比较各组BNP水平;以及BNP与LVEF、FS的相关性。结果肺炎心衰组较健康对照组和一般肺炎组血清BNP水平显著升高,[（579.0±90.0）ng·L^-1]vs[（108.6±15.0）ng·L^-1],[（579.0±90.0）ng·L^-1]vs[（121.5±10.1）ng·L^-1];LVEF和LVFS水平降低;有统计学差（P〈0.05）。肺炎心衰组血清BNP与LVEF、LVFS均呈负相关（r=-0.89,-0.78,P〈0.05）。结论肺炎心衰患儿血浆BNP水平显著升高,与左室功能呈负相关。血浆BNP水平可作为判断肺炎并心力衰竭患儿的心衰程度的指标。

Objective To investigate the changes of plasma brain natriuretic peptide（BNP） in children with pneumonia complicated with heart failure and their relationship with heart function.Methods Forty children（26 males and 14 females）with severe heart failure aged from 3 months to 2 years were selected as heart failure group.Forty children（25 males and 15 females）with ordinary pneumonia aged from 3 months to 3 years were sampled as ordinary pneumonia group.Forty healthy children（25 males and 15 females） aged from 5 months to 3 years were selected as healthy group.The peripheral blood（2-3 mL） was drawn from the children.The BNP levels were measured by ELISA,and left ventricular ejection fraction（LVEF） and left ventricular fractional shortening（LVFS） were detected by echocardiography.Plasma BNP levels in three groups were compared,and the relationship of BNP with LVEF and LVFS was analyzed.Result Compared with healthy group and ordinary pneumonia group,the levels of BNP in heart failure group increased significantly,[（579.0±90.0）ng·L^-1vs[（108.6±15.0）ng·L^-1,[（579.0±90.0）ng·L^-1vs[（121.5±10.1）ng·L^-1;while LVEF and LVFS decreased significantly（P0.05）.In addition,BNP levels were negative correlated with LVEF and LVFS in heart failure group（r=-0.89,-0.78,P〈0.05）.Conclusion Plasma BNP levels increase with a decline in left ventricular function and can be used as the index to evaluate the degree of heart failure in children with pneumonia complicated with heart failure.