重症肺炎患儿血清N末端脑钠素原和肌钙蛋白I水平变化及意义.pdf

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1、·724·临床儿科杂志第32卷第8期2014年8月JClinPediatrVo1．32No．8Aug．2014doi：10．3969／j．issn．1000—3606．2014．08．007·论著·重症肺炎患儿血清N末端脑钠素原和肌钙蛋白I水平变化及意义黄彩芝莫丽亚杨娟邓永超李爱国湖南省儿童医院检验科(湖南长沙410007)摘要：目的探讨重症肺炎患儿血清N末端脑钠素原(NT-ProBNP)和肌钙蛋l~lI(cTnI)水平的变化及其临床价值。方法重症肺炎患JL72例，分为重症肺炎无心力衰竭(HF)组(56例)与重症肺炎合

2、并HF组(16例)；另选择3O例健康儿童作为正常对照组。检测并比较各组血清NT-ProBNP和cTnI水平。结果三组间NT-ProBNP和cTnI水平差异有统计学意义(尸均=0．ooo)。重症肺炎无HF组与合并HF组的NT-ProBNP和cTnI水平高于对照组；重症肺炎合并HF组血清NT-ProBNP及cTnI水平高于重症肺炎无HF组，差异有统计学意义均<0．01)。重症肺炎患儿中，合并HF组的cTnI异常率明显高于无HF组，差异有统计学意义=0．037)，而二组的NT-ProBNP异常率差异无统计学意义(P=0．37

3、5)；重症肺炎患儿的NT-ProBNP与cTnI水平呈显著正相关=0．85，P=O．000)。结论重症肺炎患儿心肌损害明显，NT-ProBNP、cTnI可作为辅助诊断儿童重症肺炎心肌损害及严重程度的重要血清学标志物。关键词：重症肺炎；N末端脑钠素原；肌钙蛋白I；儿童ClinicalvalueofdetectingserumN-terminalpro-brainnatriureticpeptideandcardiactroponinIinchildrenwithseverepneumoniaHUANGCaizhi,MOL

4、iya，YANGJuan，DENGYongchao，LIAiguo．(TheClinicalLaboratoryDepartmentofHunanChildrenHospital,Changsha41000LHunan,ChinAbstract：OhjectiveTostudytheclinicalvalueofserumN-terminalpro-brainnatriureticpeptide(NT-ProBNP)andcardiactroponinI(cTnI)levelsinchildrenwithseverep

5、neumonia．MethodsAtotalof72childrenwithseverepneumoniainpediatricintensivecareunitweredividedintoheartfailure(HF)groupandnon—HFgroupaccordingtotheoccurrenceofheartfailure，and30healthychildrenwereselectedascontrolgroup．SerumNT-ProBNPandcTnIlevelsweredetectedandana

6、lyzed．ResultsComparedwithcontrolgroup，NT-ProBNPandcTnllevelsweresignificantlyhigher(P<0．01)inHFandnon-HFgroup．ThelevelsofNT-ProBNPandcTnIinHFgroupwerebothsignificantlyhigher(尸<0．01)thanthatinnon—HFgroup．SerumNT-ProBNPlevelwaspositivelyrelatedtothelevelofcTnI(P=0

7、．000)inchildrenwithseverepneumonia．TheabnormalrateofcTnIinHFgroupwassignificantlyhigherr尸=O．037)thanthatinnon—HFgroup．ThedifferenceoftheabnormalrateofNT-ProBNPbetweenthetwogroupswasnotsignificant(0．375)，however,theabnormalrateofNT-ProBNPwassignificantlyhigher(尸0

8、．036)thanthatofcTnIinnon—HFgroup．ConclusionsTherewasobviousmyocardialdamageinchildrenwithseverepneumonia．NT-ProBNPandcTnIcouldbeimportantserologicalmarkerstoassistdia