CAJ | 학술논문

目的：探讨重症肺炎患儿血清N末端脑钠素原(NT-ProBNP)和肌钙蛋白I(cTnI)水平的变化及其临床价值。方法重症肺炎患儿72例，分为重症肺炎无心力衰竭(HF)组(56例)与重症肺炎合并HF组(16例)；另选择30例健康儿童作为正常对照组。检测并比较各组血清NT-ProBNP和cTnI水平。结果三组间NT-ProBNP和cTnI水平差异有统计学意义(P均=0.000)。重症肺炎无HF组与合并HF组的NT-ProBNP和cTnI水平高于对照组；重症肺炎合并HF组血清NT-ProBNP及cTnI水平高于重症肺炎无HF组，差异有统计学意义(P均<0.01)。重症肺炎患儿中，合并HF组的cTnI异常率明显高于无HF组，差异有统计学意义(P=0.037)，而二组的NT-ProBNP异常率差异无统计学意义(P=0.375)；重症肺炎患儿的NT-ProBNP与cTnI水平呈显著正相关(r=0.85，P=0.000)。结论重症肺炎患儿心肌损害明显，NT-ProBNP、cTnI可作为辅助诊断儿童重症肺炎心肌损害及严重程度的重要血清学标志物。
목적：탐토중증폐염환인혈청N말단뇌납소원(NT-ProBNP)화기개단백I(cTnI)수평적변화급기림상개치。방법중증폐염환인72례，분위중증폐염무심력쇠갈(HF)조(56례)여중증폐염합병HF조(16례)；령선택30례건강인동작위정상대조조。검측병비교각조혈청NT-ProBNP화cTnI수평。결과삼조간NT-ProBNP화cTnI수평차이유통계학의의(P균=0.000)。중증폐염무HF조여합병HF조적NT-ProBNP화cTnI수평고우대조조；중증폐염합병HF조혈청NT-ProBNP급cTnI수평고우중증폐염무HF조，차이유통계학의의(P균<0.01)。중증폐염환인중，합병HF조적cTnI이상솔명현고우무HF조，차이유통계학의의(P=0.037)，이이조적NT-ProBNP이상솔차이무통계학의의(P=0.375)；중증폐염환인적NT-ProBNP여cTnI수평정현저정상관(r=0.85，P=0.000)。결론중증폐염환인심기손해명현，NT-ProBNP、cTnI가작위보조진단인동중증폐염심기손해급엄중정도적중요혈청학표지물。
Objective To study the clinical value of serum N-terminal pro-brain natriuretic peptide (NT-ProBNP) and cardiac troponin I (cTnI) levels in children with severe pneumonia. Methods A total of 72 children with severe pneumonia in pediatric intensive care unit were divided into heart failure (HF) group and non-HF group according to the occurrence of heart failure, and 30 healthy children were selected as control group. Serum NT-ProBNP and cTnI levels were detected and analyzed. Results Compared with control group, NT-ProBNP and cTnI levels were signiifcantly higher (P<0.01) in HF and non-HF group. The levels of NT-ProBNP and cTnI in HFgroup were both signiifcantly higher (P<0.01) than that in non-HFgroup. Serum NT-ProBNP level was positively related to the level of cTnI(P=0.000) in children with severe pneumonia. The abnormal rate of cTnI in HF group was significantly higher (P=0.037) than that in non-HFgroup. The difference of the abnormal rate of NT-ProBNP between the two groups was not signiifcant (P=0.375), however, the abnormal rate of NT-ProBNP was signiifcantly higher (P=0.036) than that of cTnI in non-HF group. Conclusions There was obvious myocardial damage in children with severe pneumonia. NT-ProBNP and cTnI could be important serological markers to assist diagnosis of myocardial damage and its severity.