N末端B型钠尿肽原和肌酸激酶同工酶对肺炎患儿合并心力衰竭的诊断价值

Diagnostic values of N-terminal B-type natriuretic peptide and creatine kinase isoenzyme in children with pneumonia complicated with heart failure

目的探讨N末端B型钠尿肽原(NT-proBNP)和肌酸激酶同工酶(CK-MB)对肺炎合并心力衰竭(心衰)患儿的诊断价值。方法选择2013年5月—2016年5月湖南省儿童医院收治的肺炎患儿作为研究对照,以128例合并心衰者作为肺炎合并心衰组,128例未合并心衰者作为单纯肺炎组,以同期128例健康体检儿童作为健康体检组;分别检测3组的NT-proBNP、CK-MB并进行比较分析。结果3组NT-proBNP、CK-MB相比较,肺炎合并心衰组>单纯肺炎组>健康体检组,差异均有统计学意义[NT-proBNP(ng/L):715.52±10.88、189.74±10.96、100.10±10.85,CK-MB(U/L):63.75±3.25、36.48±3.32、12.98±3.12,均P<0.05];肺炎合并心衰组内不同心衰分度患儿NT-proBNP、CK-MB相比较,重度>中度>轻度,差异均有统计学意义[NT-proBNP(ng/L):1 024.33±14.38、749.88±14.32、371.49±14.51,CK-MB(U/L):91.42±2.38、60.28±2.32、38.44±2.36,均P<0.05]。结论在肺炎患儿合并心衰的诊断中,NT-proBNP和CK-MB可为临床提供可靠的参考依据,具有重要的临床推广使用价值。

Objective To estimate the diagnostic values of N-terminal pro-B-type natriuretic peptide（NT-proBNP） and creatine kinase isoenzyme（CK-MB） in children with pneumonia complicated with heart failure. Methods From May 2013 to May 2016, the children with pneumonia admitted into the Hunan Provincial Children＇s Hospital were studied, including 128 children with pneumonia complicated with heart failure（HF） were selected as pneumonia complicated with HF group, and another 128 children suffered from pneumonia but without HF over the same period were assigned in the pneumonia alone group; in addition,128 children having undertaken health physical examinations were recognized as the health control group. The NT-proBNP and CK-MB levels of these 3 groups were detected respectively, and then, compared and analyzed among the groups. Results The comparisons of levels of NT-proBNP and CK-MB respectively among the 3 groups were of statistical significant differences, the sequence of level heights of the 2 items in the 3 groups was as follows： pneumonia complicated with HF group pneumonia alone group health control group [NT-proBNP（ng/L）： 715.52±10.88, 189.74±10.96, 100.10±10.85; CK-MB（U/L）： 63.75±3.25, 36.48±3.32, 12.98±3.12, all P〈0.05]. In pneumonia complicated with HF group, the levels of NT-proBNP and CK-MB were significantly different in children with varying degrees of HF severity, the sequence of the level heights of 2 items respectively in children with various degrees of HF severity being severe moderate mild [NT-proBNP（ng/L）： 1 024.33±14.38, 749.88±14.32, 371.49±14.51, CK-MB（U/L）： 91.42±2.38, 60.28±2.32, 38.44±2.36, all P〈0.05]. Conclusion In making a diagnosis of pneumonia complicated with heart failure in children, the detections of levels of NT-proBNP and CK-MB may provide reliable bases of reference for clinical diagnosis of this disease, so they possess important and worthwhile value to be popularized for clinical use.