检测N末端脑钠肽在不典型的川崎病早期诊断的作用

Effect of N-terminal pro-brain natriuretic peptide detection in early diagnosis of atypical Kawasaki disease

目的探讨N末端脑钠肽在不典型的川崎病早期诊断中的作用。方法回顾性分析10例川崎病小儿的临床资料,其中症状不典型的川崎病6例(症状不典型组)、症状典型的川崎病4例(症状典型组),同时选取发热5 d以上小儿6例作为对照组。入院时取静脉血,按规定检测N末端脑钠肽,并作心脏彩色B超检查。治疗10 d后进行复测。结果症状不典型组和症状典型组患儿的N末端脑钠肽检测值均呈不同程度的升高;对照组小儿N末端脑钠肽检测值未见升高。川崎病组明显高于对照组,差异具有统计学意义(P<0.01)。治疗10 d后进行复测,川崎病组的N末端脑钠肽检测值均呈现不同程度的下降或降至正常,与治疗前比较,差异均具有统计学意义(P<0.05)。结论检测N末端脑钠肽有助于早期诊断症状不典型的川崎病,并有助于评估病情和指导治疗,协助早期防治冠状动脉病变,值得临床推广应用。

Objective To investigate effect of N-terminal pro-brain natriuretic peptide in early diagnosis of atypical Kawasaki disease. Methods Clinical data of 10 children with Kawasaki disease were retrospectively analyzed. There were 6 cases with atypical Kawasaki disease （atypical symptom group） and 4 cases with typical Kawasaki disease （typical symptom group）. Another 6 children with fever for over 5 d were taken as control group. N-terminal pro-brain natriuretic peptide was detected in venous blood taken during their admission. They received heart color B ultrasound. Reexamination was made after 10 d of treatment. Results N-terminal pro-brain natriuretic peptide had different levels of increase in both atypical symptom group and typical symptom group, while the control group had no increased value. Kawasaki disease groups had much higher value than the control group, and their difference had statistical significance （P〈0.01）. Reexamination after 10 d of treatment showed that N-terminal pro-brain natriuretic peptide had different levels of decrease in Kawasaki disease groups. Compared with those before treatment, their differences all had statistical significance （P〈0.05）. Conclusion Detection of N-terminal pro-brain natriuretic peptide is helpful for early diagnosis of atypical Kawasaki disease. This method is also helpful to evaluating disease and guiding treatment, as well as early preventing coronary artery disease. It is worthy of clinical promotion and application.