中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2014年
12期
782-785
,共4页
肖政辉%刘娟%卢秀兰%胥志跃%罗海燕%祝益民
肖政輝%劉娟%盧秀蘭%胥誌躍%囉海燕%祝益民
초정휘%류연%로수란%서지약%라해연%축익민
N端B型脑钠肽%脓毒症%心肌损伤
N耑B型腦鈉肽%膿毒癥%心肌損傷
N단B형뇌납태%농독증%심기손상
N-terminal pro brain natriuretic peptide%Sepsis%Myocardial damage
目的 本研究旨在探讨N端B型脑钠肽(N-terminal pro brain natriuretic peptide,NT-proBNP)在脓毒症合并心肌损伤患儿中的临床诊断价值.方法 将2013年1月1日至6月30日入住我院PICU的162例确诊脓毒症的患儿按照是否发生心肌损伤分为非心肌损伤组和心肌损伤组,其中心肌损伤组61例(37.65％),非心肌损伤组101例(62.35％),入院24 h内对162例脓毒症患儿进行NT-proBNP、乳酸脱氢酶、肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)、肌红蛋白(MB)等检测,比较心肌损伤组与非心肌损伤组间NT-proBNP值,分析NT-proBNP与CK-MB、cTnⅠ、MB的相关性.结果 心肌损伤组NT-proBNP水平[M(Q),3 632(668.5,15 453.5) pg/ml]高于非心肌损伤组[349(169,1 500) pg/ml],差异有统计学意义(Z=91.881,P=0.000).NT-proBNP、CK-MB、cTnⅠ、MB为非正态分布资料,经对数转换后进行相关分析,logNT-proBNP与logCK-MB(r=0.367,P=0.000)、logcTnⅠ(r =0.304,P=0.001)、logMB(r=0.302,P=0.000)均呈正相关.以NT-proBNP≥1 163 pg/ml为截断点诊断心肌损伤,敏感性76％,特异性74％.结论 NT-proBNP可用来帮助诊断脓毒症合并心肌损伤.
目的 本研究旨在探討N耑B型腦鈉肽(N-terminal pro brain natriuretic peptide,NT-proBNP)在膿毒癥閤併心肌損傷患兒中的臨床診斷價值.方法 將2013年1月1日至6月30日入住我院PICU的162例確診膿毒癥的患兒按照是否髮生心肌損傷分為非心肌損傷組和心肌損傷組,其中心肌損傷組61例(37.65％),非心肌損傷組101例(62.35％),入院24 h內對162例膿毒癥患兒進行NT-proBNP、乳痠脫氫酶、肌痠激酶同工酶(CK-MB)、肌鈣蛋白Ⅰ(cTnⅠ)、肌紅蛋白(MB)等檢測,比較心肌損傷組與非心肌損傷組間NT-proBNP值,分析NT-proBNP與CK-MB、cTnⅠ、MB的相關性.結果 心肌損傷組NT-proBNP水平[M(Q),3 632(668.5,15 453.5) pg/ml]高于非心肌損傷組[349(169,1 500) pg/ml],差異有統計學意義(Z=91.881,P=0.000).NT-proBNP、CK-MB、cTnⅠ、MB為非正態分佈資料,經對數轉換後進行相關分析,logNT-proBNP與logCK-MB(r=0.367,P=0.000)、logcTnⅠ(r =0.304,P=0.001)、logMB(r=0.302,P=0.000)均呈正相關.以NT-proBNP≥1 163 pg/ml為截斷點診斷心肌損傷,敏感性76％,特異性74％.結論 NT-proBNP可用來幫助診斷膿毒癥閤併心肌損傷.
목적 본연구지재탐토N단B형뇌납태(N-terminal pro brain natriuretic peptide,NT-proBNP)재농독증합병심기손상환인중적림상진단개치.방법 장2013년1월1일지6월30일입주아원PICU적162례학진농독증적환인안조시부발생심기손상분위비심기손상조화심기손상조,기중심기손상조61례(37.65％),비심기손상조101례(62.35％),입원24 h내대162례농독증환인진행NT-proBNP、유산탈경매、기산격매동공매(CK-MB)、기개단백Ⅰ(cTnⅠ)、기홍단백(MB)등검측,비교심기손상조여비심기손상조간NT-proBNP치,분석NT-proBNP여CK-MB、cTnⅠ、MB적상관성.결과 심기손상조NT-proBNP수평[M(Q),3 632(668.5,15 453.5) pg/ml]고우비심기손상조[349(169,1 500) pg/ml],차이유통계학의의(Z=91.881,P=0.000).NT-proBNP、CK-MB、cTnⅠ、MB위비정태분포자료,경대수전환후진행상관분석,logNT-proBNP여logCK-MB(r=0.367,P=0.000)、logcTnⅠ(r =0.304,P=0.001)、logMB(r=0.302,P=0.000)균정정상관.이NT-proBNP≥1 163 pg/ml위절단점진단심기손상,민감성76％,특이성74％.결론 NT-proBNP가용래방조진단농독증합병심기손상.
Objective To evaluate the clinical value of N-terminal pro brain natriuretic peptide (NT-proBNP) in septic children with myocardial damage.Methods From Jan 1 to Jun 30,2013,162 children confirmed with sepsis in PICU of Hu'nan Children's Hospital were enrolled in the study.Patients were divided into myocardical injury and non-myocardical injury group according to whether accompanied with myocardial injury.NT-proBNP,lactate dehydrogenase,creatine kinase isoenzyme (CK-MB),troponin Ⅰ (cTnⅠ),myoglobin(MB) of patients were measured within 24 h after admission.The NT-proBNP level between two groups was compared.The correlations between NT-proBNP and cTnⅠ,CK-MB were studied respectively.Results The NT-proBNP level[M(Q)] in myocardial injury group[3 632 (668.5,15 453.5) pg/ml] was higher than that in non-myocardial injury group[349 (169,1 500) pg/ml],which was significantly different(Z =91.881,P =0.000).The levels of NT-proBNP,CK-MB,cTnⅠ,MB were abnormal distributions.There were positive correlations between logNT-proBNP and logCK-MB (r =0.367,P =0.000),logcTnⅠ(r =0.304,P =0.001) and logMB (r=0.302,P =0.000).NT-proBNP value of 1 163 ng/ml had a sensitivity of 76％ and a specificity of 74％ to diagnose myocardial injury.Conclusion NT-proBNP could help to diagnose sepsis with myocardial damage.
