氨基末端脑钠肽前体对重症手足口病患儿的评估价值

The value of NT-proBNP on the condition and prognosis in children with severe hand,foot and mouth disease

目的探讨氨基末端脑钠肽前体(NT-pro BNP)在重症手足口病患儿病情及预后中的价值。方法选取本院2013年4月至2015年10月收治的350例重症手足口患儿为研究对象,根据患儿的NT-pro BNP水平分为两组,>500 pg/m L组206例和≤500 pg/m L组144例;根据患儿的病情严重程度分为重症组218例和危重症组132例;将危重症组患儿根据存活情况分为存活组56例和死亡组76例,比较两组患儿的各实验室指标、NT-pro BNP水平以及小儿危重病例评分(PCIS)。结果>500 pg/m L组患儿的PCIS评分明显低于≤500 pg/m L组,WBC、CK-MB、尿素氮、ALT、AST均明显高于≤500 pg/m L组,两组间差异有统计学意义(P<0.05)。重症组患儿的PCIS评分明显高于危重症组,WBC、NT-pro BNP明显低于危重症组,两组间差异有统计学意义(P<0.05)。存活组患儿的WBC与死亡组比较,差异无统计学意义(P>0.05);存活组患儿的PCIS明显高于死亡组、NT-pro BNP水平低于死亡组,两组间差异有统计学意义(P<0.05)。结论 NT-pro BNP可反映重症手足口患儿病情的严重程度,并对预后具有很好的预测价值。

Objective To explore the value of NT -proBNP on the condition and prognosis in children with severe hand ,foot and mouth disease .Methods 350 children with severe hand ,foot and mouth disease treated in our hospital from April 2013 to October 2015 were selected as the object .According to the level of NT -proBNP aii the patients were divided into two groups ,206 cases were selected as 〉500 pg/mL group and 144 cases were selected as 500 pg/mL or less group;According to the patient＇s illness severity , they were divided into severe group （218 cases） and critical group （132 cases）;According to the survival situation ,they were divided into survival group （56 cases） and death group （76 cases）,two groups of children with various laboratory index ,NT-roBNP level and pediatric critical cases score （ PCIS） were compared .Results Children PCIS score of 〉500 pg/mL group was lower than that in 500 pg/mL or less group,the WBC and CK -MB,urea nitrogen,ALT and AST were significantly higher than that of 500 pg/mL or less group,the differences between the two groups were statistically significant （ P〈0.05）.PCIS score of children in severe group was ob-viously higher than that of criticalgroup ,the WBC,NT-proBNP were lower than that in criticalgroup ,the differences between the two groups were statistically significant （ P〈0.05）.The WBC of children between survive group and death group ,there was no statistically significant difference （ P〉0.05）;Children with PCIS in survival group was obviously higher than that of death group ,the NT -proB-NP level was lower than the death group ,the differences between the two groups was statistically significant （ P〈0.05）.Conclusion The NT-proBNP can reflect the severity of the children with severe hand ,foot and mouth disease ,and predict prognosis has the very good value.