小儿先天性心脏病合并心力衰竭外周血NT-proBNP、cTnI和CRP水平变化及其临床意义

Clinical Effect and Levels of Peripheral Blood NT-proBNP, cTnI and CRP in Children with Congenital Heart Disease Complicated with Heart Failure

目的研究小儿先天性心脏病(congenital heart disease,CHD)合并心力衰竭(heart failure,HF)外周血氨基末端脑利钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、肌钙蛋白I(cardiac troponini I,cTnI)及C反应蛋白(C-reactive protein,CRP)水平变化及其临床意义。方法将2016-01/2018-12月作者医院收治的62例CHD患儿纳为CHD组,选择同期30例健康儿童为对照组,比较两组儿童外周血NT-proBNP、cTnI、CRP及左室射血分数(left ventricular ejection fraction,LVEF)水平,并根据CHD患儿HF程度将其分为无HF组(n=28)、轻度HF组(n=22)及中重度HF组(n=12),分别比较3组患儿外周血NT-proBNP、cTnI、CRP及LVEF水平,分析外周血NT-proBNP、cTnI、CRP水平在评估CHD合并HF患儿病情严重程度中的价值。结果 CHD组患儿外周血NT-proBNP、cTnI、CRP及LVEF水平均显著高于对照组儿童,组间比较差异具有统计学意义(P<0.05);外周血NT-proBNP、cTnI及CRP水平在无HF组、轻度HF组及中重度HF组CHD患儿中均呈依次上升趋势,LVEF水平呈依次下降趋势,组间比较差异具有统计学意义(P<0.05)。经相关性分析发现,CHD患儿HF程度与其外周血NT-proBNP、cTnI及CRP水平均呈正相关(P<0.05),且NT-proBNP水平与LVEF水平呈明显负相关(P<0.05)。结论外周血NT-proBNP、cTnI及CRP水平与CHD合并HF患儿病情严重程度成正相关,是评估患儿病情的可靠生化指标。

Objective To study the levels changes of peripheral blood N-terminal pro-brain natriuretic peptide(NT-proBNP), cardiac troponin I(cTnI) and C-reactive protein(CRP), and their clinical significance of children with congenital heart disease(CHD) complicated with heart failure(HF). Methods A total of 62 children patients with CHD admitted to author’s hospital from January 2016 to December 2018 were included in CHD group, and another 30 healthy children at the same time period were included in control group. The levels of peripheral blood NT-proBNP, cTnI, CRP and LVEF were compared between the two groups. The CHD children patients were divided into non-HF group(n=28), mild HF group(n=22) and moderate-to-severe HF group(n=12) according to the HF degree. The levels of peripheral blood NT-proBNP, cTnI, CRP and LVEF were compared among the three groups, and the value of peripheral blood NT-proBNP, cTnI and CRP levels were analyzed in the evaluation of disease severity of children patients with CHD and HF. Results The levels of peripheral blood NT-proBNP, cTnI, CRP and LVEF in CHD group were significantly higher than those in control group(P<0.05). The levels of peripheral blood NT-proBNP, cTnI and CRP in non-HF group, mild HF group and moderate-to-severe HF group showed a sequential upward trend, and the LVEF level showed a sequential downward trend(P<0.05). Correlation analysis showed that the HF degree in children patients with CHD was positively correlated with levels of peripheral blood NT-proBNP, cTnI and CRP(P<0.05), and NT-proBNP level was negatively correlated with LVEF level(P<0.05). Conclusion The levels of peripheral blood NT-proBNP, cTnI and CRP are positively correlated with the disease severity of children patients with CHD and HF, and they are reliable biochemical indicators for evaluating the condition of children patients.