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目的:探讨脑利钠肽(brain natriuretia peptide,BNP)在川崎病(Kawasaki disease,KD)患儿中的变化及其临床意义。方法:选取36例确诊为KD的患儿为KD组,测定其急性期及恢复期的血浆BNP水平,选取36例上呼吸道感染的患儿为对照组,测定其血浆BNP水平。分别测定两组患儿外周血白细胞数(white blood cell,WBC)、C反应蛋白(C-reactive protein,CRP)及血浆心肌肌钙蛋白(cardiac troponin I,cTnI)水平;KD组行常规超声心动图检测冠状动脉病变情况。结果:KD组急性期血浆BNP水平为(468.4±200.6)ng/L,高于恢复期和对照组[(91.5±12.7)ng/L、(72.3±13.5)ng/L],差异有高度统计学意义(均P<0.01)。KD组急性期患儿行超声心动图检测有冠状动脉改变者10例,其BNP水平与无冠状动脉改变者比较,差异无统计学意义(P>0.05)。KD组急性期患儿血浆BNP水平与急性期CRP、WBC及cTnI水平呈显著正相关关系(r=0.605、0.532、0.591,均P<0.05)。结论:血浆BNP水平在KD急性期显著升高,而在疾病恢复期明显降低,有助于急性期KD的诊断,但KD患儿急性期血浆BNP水平的升高与心脏、冠状动脉损害的关系还需进一步研究。
Objective: To investigate the changes and clinical significance of brain natriuretic peptide (BNP) in children with Kawasaki disease (KD). Methods: Thirty-six children diagnosed as KD were selected as KD group. Plasma BNP levels in acute phase and convalescent phase were measured. 36 children with upper respiratory tract infection were selected as control group, and plasma BNP levels were measured. The levels of white blood cell (WBC), C-reactive protein (CRP) and cardiac troponin I (cTnI) were measured in two groups. KD group were performed routine echocardiography Figure detection of coronary lesions. Results: The level of plasma BNP in acute stage of KD group was (468.4 ± 200.6) ng / L, higher than that in convalescent stage [(91.5 ± 12.7) ng / L, (72.3 ± 13.5) ng / L] Significance (both P <0.01). In the KD group, 10 children with acute coronary artery disease underwent echocardiography. There was no significant difference in BNP level between the two groups (P> 0.05). There was a significant positive correlation between plasma BNP levels and CRP, WBC and cTnI levels in children with acute KD (r = 0.605, 0.532, 0.591, all P <0.05). Conclusions: Plasma BNP level increased significantly during acute KD phase and significantly decreased during convalescent phase of disease, which is helpful for the diagnosis of KD in acute phase. However, the relationship between plasma BNP level and the damage of heart and coronary artery in acute KD children Need further study.