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目的探讨血浆脑钠素(BNP)、肌钙蛋白I(cTnI)质量浓度的变化在心力衰竭(简称心衰,CHF)患儿的临床诊断、预后评估中的意义。方法2003-02—2005-02于青岛市海慈医院住院诊断心衰的患儿41例,同时选健康体检者41例作为正常对照组,采用放射免疫分析法分别检测其血BNP及cTnI的水平。结果心衰早期BNP、cTnI即开始升高,心衰期达高峰,恢复期逐渐下降,但仍高于正常对照组(P<0.01);心衰早期、恢复期BNP阳性率(92.7%,90.2%)较cTnI阳性率(63.4%,58.5%)差异有显著性(P<0.01);BNP持续高于500ng/L的心脏事件发生率(66.7%)较BNP<500ng/L的心脏事件发生率(21.4%)高,差异有显著性(P<0.01)。结论心衰患儿血浆BNP、cTnI质量浓度明显升高,BNP、cTnI可反映其心肌损伤;血浆BNP在心衰早期诊断方面,其敏感性及特异性均优于cTnI,可作为诊断小儿心衰的一项重要指标;血浆BNP则可作为判断预后的一个重要参考依据。
Objective To investigate the significance of the changes of plasma brain natriuretic peptide (BNP) and troponin I (cTnI) in the clinical diagnosis and prognosis of children with heart failure (CHF). Methods From February 2003 to February 2005, 41 children with heart failure diagnosed as hospitalized in Qingdao Haici Hospital and 41 healthy controls were selected as normal control group. . Results BNP and cTnI began to increase in the early stage of heart failure, the peak of heart failure peaked, and the recovery period gradually decreased, but still higher than that of the normal control group (P <0.01). In the early stage of heart failure, the positive rate of BNP in recovery period was 92.7% and 90.2 %) Was significantly higher than that of cTnI (63.4%, 58.5%) (P <0.01). The incidence of cardiac events with BNP level higher than 500ng / L (66.7%) was significantly higher than that with BNP <500ng / L (21.4%), the difference was significant (P <0.01). Conclusions Plasma BNP and cTnI levels are significantly elevated in children with heart failure, BNP and cTnI may reflect the myocardial injury. BNP is superior to cTnI in the early diagnosis of heart failure, which may be used as a diagnostic method in children with heart failure Of an important indicator of plasma BNP can be used as an important reference to determine the prognosis.