C-反应蛋白与B型钠尿肽评估先天性心脏病肺部感染患儿心功能的临床研究

Clinical value of C-reactive protein combined with B-type natriuretic peptide in evaluation of cardiac function of congenital heart disease children with pulmonary infections

目的探讨C-反应蛋白联合B型钠尿肽(BNP)指标评估先天性心脏病肺部感染患儿心功能的临床应用价值。方法收集2010年1月-2013年8月诊断为先天性心脏病合并肺部感染患儿50例为患儿组,以健康儿童50名作为对照组,监测BNP以及C-反应蛋白的变化,采用SPSSl5.0软件对收集的资料进行统计分析。结果先天性心脏病合并肺部感染患儿BNP与C-反应蛋白指标分别为(522.2±45.3)pg/ml、(15.2±8.3)mg/L,高于健康组儿童的(25.4±8.4)pg/ml、(4.3±1.1)mg/,两组比较差异有统计学意义(P<0.01);50例患儿入院后给予积极治疗干预,治疗后BNP与C-反应蛋白指标分别下降至(37.4±8.4)pg/ml、(8.8±1.3)mg/L,差异有统计学意义(P<0.01);不同心功能患儿BNP与C-反应蛋白指标组间比较,差异均有统计学意义(P<0.05),心功能越差患儿的BNP指标和C-反应蛋白指标越高;对不同心功能分级与BNP、C-反应蛋白进行相关性分析,显示之间具有正相关,其中BNP与心功能之间相关性(r=0.81,P<0.01),C-反应蛋白与心功能相关性(r=0.43,P<0.05)。结论临床根据C-反应蛋白联合BNP评价先心病肺部感染评价心功能具有较强的可靠性,在临床上应该给予重视。

OBJECTIVE To explore the clinical value of C-reactive protein combined with B-type natriuretic peptide （BNP） in evaluation of the cardiac function of congenital heart disease （CHD） children with pulmonary infections. METHODS Totally 50 children, who were diagnosed as the CHD complicated with pulmonary infections from Jan 2010 to Aug 2013, were chosen as the case group, meanwhile, 50 healthy children were set as the control group, then the changes of BNP and C-reactive protein were monitored, and the statistical analysis of the obtained data was performed with the SPSS15. 0 software. RESULTS The levels of BNP and C-reactive protein of the CHD children complicated with pulmonary infections were（522. 2±45. 3）pg/ml and （15. 2±8. 3）mg/L, higher than （25. 4±8. 4）pg/ml and （4. 3±1.1）mg/L of the healthy children in the control group; the difference between the two groups was statistically significant （P〈0. 01）. After the implementation of active interventions, the levels of BNP and C-reactive protein of the 50 children respectively decreased to （37. 4±8. 4）pg/mL and （8. 8±1. 3）mg/L, the difference was statistically significant （P〈0. 01）. The difference in the level of BNP or C-reactive protein among the children with different cardiac functions was statistically significantf P＇〈i O, 05）. The poorer the cardiac function, the higher the level of BNP or C-reactive protein was. The study concluded that the cardiac function was positively correlated with the BNP or C-reactive protein, with the correlation between the BNP and cardiac function （r = 0. 81, P 〈 0. 01） , the correlation between the C-reactive protein and cardiac function （r = 0. 43, P〈0. 05）. CONCLUSION It is reliable to use the BNP combined with C-reactive protein as an indicator for evaluation of cardiac function of the CHD children with pulmonary infections, to which great attention should be paid.