毛细支气管炎并急性心力衰竭患儿血浆NT-ProBNP和BNP的变化及其临床意义

Clinic significance and variation of plasma N-terminal probrain natriuretic peptide precursor and brain natriuretic peptide in children with bronchiolitis and acute heart failure

目的探讨血浆N末端脑利钠肽前体(NT-ProBNP)及脑利钠肽(BNP)对毛细支气管炎合并急性充血性心力衰竭(AHF)早期诊断的临床意义。方法选择2009-10～2011-03在青岛市妇女儿童医院住院的毛细支气管炎患儿60例为研究对象,随机分为对照组(未合并AHF)33例,AHF组(合并AHF)27例。采用酶联免疫吸附(ELISA)法检测血浆NT-ProBNP和BNP,并行心脏彩超多普勒(UCG)检测左室射血分数(LVEF)。结果 AHF组患儿血浆NT-ProBNP和BNP明显高于对照组(P<0.01),LVEF明显低于对照组(P<0.01)。AHF组患儿血浆NT-proBNP与LVEF呈显著负相关(r=-0.62,P<0.01),BNP与LVEF呈负相关(r=-0.39,P<0.05)。结论血浆NT-proBNP和BNP浓度对于毛细支气管炎合并AHF的诊断具有较高的敏感性和特异性,可以作为其早期诊断指标。

Objective To investigate the clinical significance and diagnostic value of the concentrations of plasma NT-proBNP and BNP in children with bronchiolitis and acute congestive heart failure（AHF）. Methods The concentration of plasma NT-proBNP and BNP were determined in the children with bronchiolitis （ n = 60, among the children 27 in AHF group,33 in controls） by enzyme-linked-immunosorbent serologic assay（ ELISA）, and LVEF were measured by two-dimensional echocardiography. Results The plasma concentrations of NT-proBNP and BNP were much higher in AHF children than those in controls （ without AHF） （P 〈 O. 01 ）. The NT-proBNP and BNP lev- els in AHF group had negative correlation with LVEF（r = -0. 62,P 〈0. 01 ; r = -0.39,P 〈0. 05）. Conclusion Plasma NT-proBNP and BNP level may be the more valuable laboratory plasma marker for prognosis and diagnosis of bronchiolitis with acute congestive heart failure.