体质对肺炎心衰患儿血清氨基末端脑利钠肽前体和超敏C反应蛋白水平的影响

Effect of physical constitution on serum levels of NT-proBNP and hsCRP in children with pneumonia complicated by heart failure

目的：探讨体质对肺炎心衰患儿血清氨基末端脑利钠肽前体（NT-proBNP）、超敏C反应蛋白（hsCRP）水平的影响,评估其临床价值.方法：选择116例1～3岁肺炎心衰患儿作为观察组,并选择正常体检的98例1～3岁儿童作为对照组.测量观察对象的身高、体质量,根据幼儿Kaup指数将患儿分为正常组、优良组及肥胖组.测定观察对象血浆NT-proBNP、hsCRP水平,并对检测结果进行分析.结果：观察组各组NT-proBNP水平均显著高于对照组,NT-proBNP水平与Kaup之间存在负相关,NT-proBNP水平随肥胖程度加重而逐渐降低;观察组各组hsCRP水平均显著高于对照组,hsCRP水平与Kaup之间存在正相关,hsCRP水平随肥胖程度加重而逐渐升高.结论：体质状况显著影响肺炎心衰患儿血清NTproBNP和hsCRP水平,血清NTproBNP水平随Kaup增加而降低,hsCRP水平随Kaup增加而升高,联合检测血浆NT-proBNP和hsCRP水平有利于肥胖肺炎心衰患儿的诊断及预后评估.

Objective： To explore the effect of physical constitution on serum N-terminal pro-brain natriuretic peptide （NT- proBNP） and high sensitivity C-reactive protein （hsCRP） in children with pneumonia complicated by heart failure, and to assess its clinical values. Methods： 116 patients aged 1-3 years with pneumonia complicated by heart failure were enrolled in this study （60 males, 65 females and cardiac function gradeⅡ ） as an observation group, 98 healthy children aged 1-3 years （50 males, 48 females） were enrolled as a control group. The height and weight of each object were measured, and infant Kaup index were calculated with these parameter. The objects were divided into 3 groups according to Kaup index： a normal group, an excellent group and an obese group. The serum levels of NT-proBNP and hsCRP were detected, and the results were analyzed. Results： The levels of NT-proBNP were significantly higher in the observation group compared to the control group, and were significantly inversely correlated with Kaup. The levels of NT-proBNP decreased with the rise of Kaup. The levels of hsCRP were significantly higher in the observation group compared to the control group. While the levels of hsCRP were significantly positively correlated with Kaup, and were increased with the rise of Kaup. Conclusion： In children with pneumonia complicated by heart failure, plasma NT-proBNP and hsCRP levels are all affected significantly by physical constitution. The levels of NT-proBNP decreased with the rise of Kaup, while the levels of hsCRP increased with the rise of Kaup. Simultaneous determination of the two markers is significant in the diagnosis and prognosis for obesity patients with pneumonia complicated by heart failure.