摘要
目的探讨氨基末端脑钠素原(NT-proBNP)在小儿先天性心脏病(先天性心脏病)并肺动脉高压(肺高压)的诊断价值。方法2005年1月至2007年3月山东大学齐鲁儿童医院内科采用竞争性酶免疫法检测20例正常对照组小儿及65例先天性心脏病患儿血清NT-proBNP浓度。65例先天性心脏病患儿经用彩色多普勒超声心动图估测肺动脉压力,分为三组:无肺高压组20例、轻度肺高压组23例、中重度肺高压组22例。结果1、先天性心脏病无肺高压组较正常对照组NT-proBNP水平略有增高,但无明显统计学差异(P>0.05)。2、先天性心脏病并轻度肺高压组NT-proBNP水平明显高于先天性心脏病无肺高压组(P<0.001)。3、中重度肺高压组患儿NT-proBNP水平较轻度肺高压组明显增高(P<0.001)。4、以500 fmol/m l诊断轻度肺高压的敏感度为91%,特异度为90%,且经直线相关分析,显示NT-proBNP与肺高压高低呈正相关,r=0.80。结论血清NT-proBNP检测对先天性心脏病并肺高压具有敏感而特异的诊断价值,且可反映肺动脉压增高程度。
Objective To study the diagnostic value of the serum level of N-terminal pro-brain natriuretic peptide（ NT- proBNP）in pediatric patients with congenital heart disease（CHD） complicated by pulmonary hypertension（PH）. Methotis The serum NT-proBNP concentration was detected with competitive enzyme immunoassay（ EIA ） in 65 CHD children and 20 control children. Pulmonary pressure was estimated by Doppler uhrasonography cardiogram in 65 CHD children who sere divided into three groups ： without PH （ 20 ）, mild PH （23）, moderate to severe PH （ 22 ）. Results 1. NT-proB- NP concentrations in the CHD group without PH were slightly higher than those in normal control group, but there was no statistic significance （ P 〉 0. 05 ）. 2. The NT-proBNP level in CHD group with mild PH was significantly higher than that in CHD group without PH （ P 〈 0. 001 ）. 3.The NT-proBNP level in CHD group with moderate to severe PH was also significantly higher than that in CHD group with mild PH （ P 〈 0. 001 ）. 4. Using serum NT-proBNP concentration = 500fmoL/ml as cut-point for diagnosing mild PH, the sensitivity was 91%, and the specificity was 90%. Serum NT-proBNP was also positively correlated with increased pulmonary pressure. Conclusion Serum NT-proBNP level is sensitive and specific for the diagnosis of CHD complicated by PH. There is a rising tendency of NT-proBNP level companying increased pulmonary pressure.
出处
《中国实用儿科杂志》
CSCD
北大核心
2008年第11期848-850,共3页
Chinese Journal of Practical Pediatrics
关键词
氨基末端脑钠素原
肺动脉高压
先天性心脏病
N-terminal pro-brain natriuretic peptide
Pulmonary hypertension
Congenital heart disease
