摘要
目的探讨败血症并心肌损伤新生儿血浆脑钠肽(BNP)及氨基末端脑钠肽(NT-proBNP)水平变化的意义。方法兰州大学第二医院儿科NICU2007年7月-2008年6月根据新生儿败血症诊疗方案临床诊断新生儿败血症45例,再根据心肌损伤诊断标准分为心肌损伤组22例和非心肌损伤组23例;心肌损伤组根据超声心动图结果分为先天性心脏病(先心病)组和非先心病组;选取同期30例健康新生儿作为健康对照组。分别留取各组儿童血标本检测CK-MB、肌钙蛋白I(cTnI),ELISA法检测其血浆BNP和NT-proBNP水平。结果心肌损伤组与非心肌损伤组及健康对照组BNP、NT-proBNP、CK-MB、cTnI水平比较均有显著性差异,心肌损伤组明显高于非心肌损伤组和健康对照组,其中先心病组新生儿血浆BNP和NT-proBNP均明显高于非先心病组(Pa<0.05)。经ROC曲线分析,BNP与NT-proBNP诊断心肌损伤的特异性和敏感性差异均无统计学意义(Pa>0.05)。结论BNP和NT-proBNP可联合CK-MB、cTnI早期诊断新生儿败血症并心肌损伤及心力衰竭,NICU的败血症患儿应常规检测BNP和NT-proBNP,有助于早期诊断新生儿败血症并心肌损伤。
Objective To explore the changes of plasma brain natriuretic peptide（BNP） and N - terminal pro - B - type natriuretic peptide （ NT - proBNP） of sepsis combined with myocardial injury in newborns. Methods According to neonatal sepsis treatment program,45 cases of sepsis newborns in NICU of the Second Hospital in Lanzhou University from Jul. 2007 to Jun. 2008 were collected. According to the myocardial injury diagnostic criteria,45 cases neonatal sepsis were divided into myocardial injury group（n = 22） and non - myocardial injury group（ n = 23 ）. Myocardial injury group was also divided into congenital heart disease group and non - congenital heart disease group according to echocardiography. At the same time,30 healthy newborns were collected as healthy control group. Every newborns were tested the level of plasma BNP, NT - proBNP,ereatine kinase - MB（ CK - MB） and cardiac - troponin l （cTnI）. Results There were significant difference between myocardial injury group, non- myocardial injury group and healthy control group in the levels of plasma BNP, NT- proBNP, CK- MB and cTnI,those in congenital heart disease group were higher than those in non- myocardial injury group and the healthy control group（ P 〈 0. 05 ） , the levels of plasma BNP and NT- proBNP in congenital heart disease group were higher than those in non -congenital heart disease group（ P 〈 0.05 ）. Through ROC curve analysis, there was no statistic sense of sensitivity and specificity of BNP and NT -proB- NP diagnose on myocardial injury. （P 〉 0.05 ）. Conclusions BNP and NT - proBNP can be early used to diagnose myocardial injury and heart failure of neonatal sepsis associated with CK - MB and cTnI. In NICU,infants with sepsis should normally test BNP and NT - proBNP in order to early diagnose myocardial injury of ueonatal sepsis.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2009年第10期748-750,共3页
Journal of Applied Clinical Pediatrics
基金
甘肃省自然科学基金项目资助(3ZS061-A25-100)
关键词
婴儿
新生
败血症
心肌损伤
脑钠肽
氨基末端脑钠肽
infant, newborn
sepsis
myocardial injury
brain natriuretic peptide
N - terminal pro - B - type natriuretic peptide
