CAJ | 학술논문

目的通过观察川崎病(KD)患儿脑利钠肽(BNP)的水平变化,并与肌钙蛋白Ⅰ(cTrⅠ)比较,探讨其在KD早期诊断中的作用.方法选择住院KD患儿21例作为研究对象,20例健康体检儿童作为对照组.对KD组及对照组采用酶联免疫吸附法测定血浆BNP、cTnⅠ浓度,并行心脏多普勒超声检查测定冠状动脉内径.结果 KD患儿血浆BNP水平[(517.26±213.40)μg/L]明显高于对照组[(37.55±7.56)μg/L],差异有非常显著性(P＜0.01);cTnⅠ浓度[(0.31±0.17)μg/L]也高于对照组[(0.13±0.04)μg/L],差异有显著性(P＜0.01).KD患儿BNP异常率(100%)明显高于cTnⅠ(47.7%),差异有非常显著性(P＜0.01);冠状动脉病变组血浆BNP、cTnⅠ水平明显高于非冠状动脉病变组;典型KD患儿及不完全型KD患儿BNP及cTnⅠ血浆水平间差异无显著性(P＞0.05).结论 KD患儿血浆BNP、cTnⅠ浓度均明显升高,而BNP具有更高的特异性及灵敏度.血浆BNP水平测定有助于KD的诊断,尤其是不完全型KD早期诊断.
목적 통과관찰천기병(KD)환인뇌리납태(BNP)적수평변화,병여기개단백Ⅰ(cTrⅠ)비교,탐토기재KD조기진단중적작용.방법 선택주원KD환인21례작위연구대상,20례건강체검인동작위대조조.대KD조급대조조채용매련면역흡부법측정혈장BNP、cTnⅠ농도,병행심장다보륵초성검사측정관상동맥내경.결과 KD환인혈장BNP수평[(517.26±213.40)μg/L]명현고우대조조[(37.55±7.56)μg/L],차이유비상현저성(P＜0.01);cTnⅠ농도[(0.31±0.17)μg/L]야고우대조조[(0.13±0.04)μg/L],차이유현저성(P＜0.01).KD환인BNP이상솔(100%)명현고우cTnⅠ(47.7%),차이유비상현저성(P＜0.01);관상동맥병변조혈장BNP、cTnⅠ수평명현고우비관상동맥병변조;전형KD환인급불완전형KD환인BNP급cTnⅠ혈장수평간차이무현저성(P＞0.05).결론 KD환인혈장BNP、cTnⅠ농도균명현승고,이BNP구유경고적특이성급령민도.혈장BNP수평측정유조우KD적진단,우기시불완전형KD조기진단.
Objective To determine the serum levels of brain natriuretie peptide(BNP)and cardiac troponin I(cTnⅠ)in children with Kawasaki disease(KD),and to assess their value in the early diagnosis of KD.Methods Serum levels of BNP and cTnI were measured in 21 KD children(KD group)and 20 healthy children as control group by enzyme-linked immunoabsorbent assay.The internal diameter of coronary artery was measured by two-dimensional eehocardiography.Results Mean serum level of BNP[(517.26±213.40)μg/L]was significantly higher than that in the control group[(37.55±7.56)μg/L](P ＜ 0.01),and cTnI level[(0.31±0.17)μg/L]was significantly higher than that of the control group[(0.13±0.04)μg/L](P ＜0.01).Among KD patients,the percentage of patients with increased BNP(100%)was significantly higher than that of increased cTnⅠ(47.7%),there was significant difference(P ＜ 0.01).Serum levels of BNP and cTnⅠ in the coronary artery lesion(CAL)group were significantly higher than those in the group without coronary artery lesion(NCAL)[(719.33±221.17)μg/L vs(416.23±120.45)μg/L,(0.44±0.22)μg/L vs(0.24±0.11)μg/L,t = 3.03,2.52,P ＜ 0.05].There were no significant difference in serum BNP and cTnⅠ concentrations between the typical and incomplete KD group[(536.15±243.80)μg/L vs(515.71±208.16)μg/L,(0.33±0.21)μg/L vs(0.31±0.16)μg/L,t = 1.06,1.21,P＞0.05].Conclusion Serum levels of BNP and cTnⅠ increase significantly in the KD patients,and BNP has higher sensitivity and specificity than cTnⅠ.Serum BNP level is useful for diagnosis of KD,especially for the incomplete KD.