N端脑利钠肽前体在儿科疾病中诊断及预测价值的研究进展

Progress of diagnosis and predictive value of N-terminal pro-brain natriuretic peptide in pediatric diseases

N端脑利钠肽前体(N-terminalpro-brain natriuretic peptide,NT-proBNP)是一种由心脏分泌利钠肽类激素,小部分由脑分泌.脑利钠肽前体(proBNP)在分泌过程中进入血液后分解为无生物活性的NT-proBNP和具有生物活性的BNP.proBNP血浆浓度与心室体积或压力负荷程度成正比,稳定性好,定量分析测定值高,具有利钠、利尿、扩张血管、抑制肾素-血管紧张素-醛固酮系统(RAAS)和交感神经系统活性作用.儿童血浆NT-proBNP水平不受胎龄、性别、出生体质量、分娩方式及营养方式的影响.NT-proBNP是儿科心血管系统疾病、呼吸系统疾病、新生儿疾病、感染性疾病、川崎病及其他疾病诊断的特异性指标,具有较好的预测价值,可作为判断病情的敏感指标.随着研究的深入NT-proBNP将在儿科疾病的诊断、危险分层、监控治疗、预后评估等方面发挥重要作用.该文就NT-proBNP的生物学特性、检测方法、正常值范围及在儿科疾病的诊断和预测价值的研究进展作一综述.

N-terminal pro-brain natriuretic peptide (NT-proBNP)is an endocrine hormone mainly derived from heart,partly from brain.During its process of secreting into blood,proBNP is decomposed into biological active BNP and biological inactive NT-proBNP.The plasma concentration of NT-proBNP is proportional to the ventricular volume and pressure,thus it is stable and has high value of quantitative analysis.NT-proBNP has strong effects on natriuresis,diuresis,dilation of blood vessels,and inhibition of renin angiotensin aldosterone system (RAAS)and sympathetic nervous system activity.The level of NT-proBNP in children's plasma is not affected by gestational age,sex,and birth weight,mode of delivery and nutrition of children.NT-proBNP is a specific indicator for diagnosing pediatric cardiovascular system disease,respiratory system disease,neonatal diseases,infectious diseases,kawasaki disease and other diseases,and should be used as a sensitive index to monitor the condition of diseases for its good predictive value.With the development of the research,NT-proBNP will play an increasingly important role in the diagnosis,risk stratification,monitoring treatment and prognostic evaluation of pediatric diseases.This article mainly reviews the biological characteristics,detective methods,normal range and diagnostic and predictive value of NT-proBNP in pediatric diseases.