生物标志物在儿童心力衰竭中的临床应用

Clinical use of biomarkers in pediatric heart failure

心力衰竭涉及神经激素控制、炎性反应、氧化应激、细胞外基质矩阵重建、心肌细胞损伤、心肌细胞应力等生物过程，在每个过程中均有反映其特异性的生物标志物，可以应用这些标志物对心力衰竭进程加以评估。在儿童患者中，通过病史、症状、体征等临床特征难以客观评估心力衰竭的严重程度和病程，需要结合生物标志物来更准确地评估患儿病情。当前生物标志物被越来越多地应用于心力衰竭的早期诊断、鉴别诊断、危险度分层、治疗指导、预后判断及靶向治疗策略选择等。现就近年来一些重要的生物标志物在儿童心力衰竭中的临床应用作一综述。

Heart failure includes many biological courses, such as neurohormonal, inflammation, oxid-ative stress, extracellular matrix remodeling, myocyte injury, myocyte stress, et al. All of these courses have their specific biomarkers ,which can be used to estimate the process of heart failure. It is difficult to estimate pediatric heart failure severity and stage objectively just with medical histories, symptoms and signs. So these clinical characteristics needed to link up with the biomarkers. At present, biomarkers are getting into more extensive use in heart failure, including early diagnosis, differential diagnosis, risk stratification, therapy guiding, prognostic indication and calculation of targeted therapeutic strategies,et al. This review puts emphasis on the clinical use of some important biomarkers in pediatric heart failure.