论著 Original Article

血清NT-proBNP和肌钙蛋白Ⅰ与肺炎合并心力衰竭患儿改良Ross评分的相关性分析

Published at: 2015年第35卷第12期

夏翠林 1
1 浠水县人民医院儿科,湖北 黄冈 438200
通讯作者 翠林 夏 Email: xiacuilin@126.com
DOI: 10.3978/j.issn.2095-6959.10.3978/j.issn.2095-6959.2015.12.025
基金:

摘要

目的:探讨血浆氨基N末端B型利钠肽前体(NT-proBNP)和肌钙蛋白Ⅰ(cTnI)与肺炎合并心力衰竭患儿改良Ross评分的相关性分析。方法:选取2013年1月至2014年12月我院收治的支气管肺炎患儿102例为研究对象,依据入院时小儿心力衰竭改良Ross评分分为无心力衰竭组、轻度心力衰竭组及中–重度心力衰竭组,检测患儿入院时血清NT-proBNP、cTnI,并记录患儿心脏超声指标左室射血分数(left ventricular ejection fraction,LVEF)以及左室缩短分数(left ventricular shortening fraction,LVFS),同期选取我院健康体检的婴幼儿50例作为参照对照组。结果:四组患者血清NT-proBNP、cTnI、LVEF、LVFS之间比较具有统计学差异(P<0.05),中–重度心力衰竭组NT-proBNP、cTnI高于轻度心力衰竭组、无心力衰竭组及对照组,轻度心力衰竭组高于无心力衰竭组及对照组;中–重度心力衰竭组LVEF、LVFS高于轻度心力衰竭组、无心力衰竭组及对照组,轻度心力衰竭组高于无心力衰竭组及对照组;中–重度心力衰竭组及轻度心力衰竭组治疗后7 d的NT-proBNP、cTnI均较治疗前下降(P<0.05),但中–重度心力衰竭组7 d的NT-proBNP、cTnI仍高于轻度心力衰竭组(P<0.05);多重线性回归分析显示:NT-proBNP、cTnI分别与Ross评分呈正相关,而与LVEF呈负相关(P<0.05);ROC曲线分析显示:入院治疗前血清NT-proBNP、cTnI预测肺炎患儿发生心力衰竭(改良Ross评分≥3分)的曲线下面积(ROCAUC)分别为:0.882、0.823;灵敏度分别为:90.1%,87.9%;特异度分别为:79.6%,78.1%。结论:血清NT-proBNP、cTnI与肺炎合并心衰患儿心衰病情严重程度密切相关,两者均能够评估患儿心力衰竭分级状态,且NT-proBNP在诊断心衰的临床价值方面优于cTnI。


Correlation of serum NT-proBNP and troponin I with modified Ross score in children with pneumonia complicated heart failure

Abstract

Objective: To investigate the correlation of serum NT-proBNP and troponin I (cTnI) with modified Ross score in children with pneumonia complicated heart failure. Methods: A total of 102 cases of children with bronchial pneumonia in our hospital from January 2013 to December 2013. Selected as the research subjects, all children were divided into non-heart failure group, mild heart failure group and severe heart failure group on the basis of modified Ross score, serum NT-proBNP, cTnI were detected when children admitted to hospital, and recorded the left ventricular ejection fraction (LVEF) and left ventricular shortening fraction (LVFS); healthy check-up infants and young children were choose as control group at the same time. Results: There were statistically difference in NT-proBNP, cTnI, LVEF and LVFS among four groups (P<0.05); serum NT-proBNP, cTnI level of severe heart failure group were higher than those of mild, non-heart failure and control group; serum NT-proBNP, cTnI level of mild heart failure group were higher than those of non-heart failure and control group (P<0.05); LVEF and LVFS of severe heart failure group were lower than those of mild, non-heart failure and control group (P<0.05); LVEF and LVFS of mild heart failure group were lower than those of non-heart failure and control group (P<0.05); serum NT-proBNP, cTnI level of severe, mild heart failure group decreased after 7 d treatment (P<0.05), however, serum NT-proBNP, cTnI level of severe heart failure group were higher than those of mild heart failure group (P<0.05); multiple linear regression analysis showed that NT-proBNP and cTnI were positively correlated with modified Ross score, and negative correlated with LVEF (P<0.05); ROC curve analysis showed that ROCAUC of serum NT-proBNP and cTnI predicting the heart failure (modified Ross score≥3 points) were 0.882, 0.823, respectively; sensitivity were 90.1%, 87.9% respectively: specific degrees were 79.6%, 79.6%, respectively. Conclusion: Serum NT-proBNP, cTnI are closely related to heart failure severity in children with pneumonia, both indexes are used to assess classification status of heart failure; and NT-proBNP is better than that of cTnI in terms of the clinical value of diagnosis of heart failure.


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引用本文: 翠林 夏. 血清NT-proBNP和肌钙蛋白Ⅰ与肺炎合并心力衰竭患儿改良Ross评分的相关性分析[J]. 临床与病理杂志, 2015, 35(12): 2139-2144.
Cite this article as: XIA Cuilin . Correlation of serum NT-proBNP and troponin I with modified Ross score in children with pneumonia complicated heart failure[J]. Journal of Clinical and Pathological Research, 2015, 35(12): 2139-2144.