氨基末端脑钠肽和肌钙蛋白I联合检测在儿童肺炎并心力衰竭诊断中的应用

Role of N-terminal pro-brain natriuretic peptide and troponin I in the diagnosis of children with pneumonia complicated with heart failure

目的探讨氨基末端脑钠肽(NT-pro-BNP)和肌钙蛋白I(c Tn I)联合检测在儿童肺炎并心力衰竭诊断中的价值。方法选取儿童肺炎心衰、单纯肺炎和健康对照组各30例,检测三组受试者的NT-pro-BNP、c Tn I和心肌功能水平,并分析其关联性。结果肺炎心衰组的左室射血分数(LEVF)、左室短轴缩短率(LVFS)明显低于单纯肺炎组和健康对照组,而c Tn I、NT-pro-BNP水平明显高于另外两组(P<0.05);c Tn I与LEVF、NT-pro-BNP与LEVF均呈负相关,而c Tn I与NT-pro-BNP则呈正相关(P<0.05);c Tn I阳性组患者年龄、LEVF明显低于c Tn I阴性组,NT-pro BNP明显高于c Tn I阴性组(P<0.05);NT-pro-BNP、c Tn I联合检测对肺炎合并心衰的灵敏度和特异度均改善,灵敏度达86.67%,特异度达96.67%。结论 c Tn I、NT-pro-BNP联合检测诊断儿童肺炎心衰,灵敏度和可靠度均明显提高。

Objective To analyze the role of N-terminal pro-brain natriuretic peptide （NT-pro-BNP） and tro-ponin I （cTnI） in the diagnosis of children with pneumonia complicated with heart failure. Methods Thirty children with pneumonia complicated with heart failure （group A）, 30 children only with pneumonia （group B）, and 30 healthy children （group C） were recruited to detect the levels of NT-pro-BNP, troponin I, and myocardial function The rele-vance and value of the three indexes were analyzed. Results The left ventricular ejection fraction （LEVF） and the left ventricular fractional shortening （LVFS） of group A were significantly lower than those of group B and group C, while cTnI, NT-pro-BNP levels of group A were significantly higher than other two groups （P〈0.05）. cTnI and NT-pro-BNP were both negatively correlated with LEVF, while cTnI and NT-pro-BNP showed a positive correlation （P〈0.05）. Patients with positive cTnI were found with younger age and lower LEVF than those with negative cTnI （P〈0.05）. The sensitivity and specificity of combined detection of NT-pro-BNP and troponin I for pneumonia complicat-ed by heart failure were improved to 86.67%and 96.67%. Conclusion In the diagnosis of pneumonia with heart fail-ure, the combined detection of cTnI and NT-pro-BNP, has significantly improved sensitivity and reliability and better clinical effect.