CAJ | 학술논문

目的：观察 N 端脑钠肽前体（NT‐proBNP）在小儿川崎病（KD）中的变化及临床诊断价值。方法选取该院KD患儿91例（KD组），以同期住院的80例呼吸道感染伴发热并排除心肌受累的患儿为对照组，分别测定KD急性期血浆NT‐proBNP水平，并分析其与不同的临床和实验室资料的关系。结果 KD组NT‐proBNP水平为（1042．38±528．7） pg／mL ，明显高于对照组（458．6±412．3）pg／mL ，差异有统计学意义（P＜0．05）。直线相关分析显示，KD患儿急性期血浆NT‐proBNP水平与CRP水平呈正相关（ r＝0．442，P＜0．05 ），与血细胞比容、血钠及血清蛋白呈负相关（分别为 r＝－0．216，P＝0．045；r＝－0．204，P＝0．041；r＝－0．315，P＝0．0003）。NT‐proBNP诊断KD的ROC曲线下面积为0．881，诊断界值530 pg／mL ，特异性和灵敏度分别为70．1％、84．0％。结论 KD急性期NT‐proBNP明显升高，可作为诊断KD的一个可靠指标，并且高水平的NT‐proBNP与系统性炎症相关。
목적：관찰 N 단뇌납태전체（NT‐proBNP）재소인천기병（KD）중적변화급림상진단개치。방법선취해원KD환인91례（KD조），이동기주원적80례호흡도감염반발열병배제심기수루적환인위대조조，분별측정KD급성기혈장NT‐proBNP수평，병분석기여불동적림상화실험실자료적관계。결과 KD조NT‐proBNP수평위（1042．38±528．7） pg／mL ，명현고우대조조（458．6±412．3）pg／mL ，차이유통계학의의（P＜0．05）。직선상관분석현시，KD환인급성기혈장NT‐proBNP수평여CRP수평정정상관（ r＝0．442，P＜0．05 ），여혈세포비용、혈납급혈청단백정부상관（분별위 r＝－0．216，P＝0．045；r＝－0．204，P＝0．041；r＝－0．315，P＝0．0003）。NT‐proBNP진단KD적ROC곡선하면적위0．881，진단계치530 pg／mL ，특이성화령민도분별위70．1％、84．0％。결론 KD급성기NT‐proBNP명현승고，가작위진단KD적일개가고지표，병차고수평적NT‐proBNP여계통성염증상관。
Objective To explore the diagnostic value of N‐terminal Pro‐Brain Natriuretic Peptide (NT‐proBNP) in Kawasaki disease (KD) in children .Methods Ninety one children with KD were collected and 80 patients with acute upper respiratory infec‐tion were used as controls .Plasma NT‐pro BNP concentrations and other laboratory date were collected in the acute of KD .The re‐lationships between NT‐pro BNP values and different clinical and laboratory data in the acute phase were sought .Results The mean plasma NT‐pro BNP concentration in patients with KD in the acute phase was (1 042 .38 ± 528 .7)pg/mL ,significantly higher than those of control group(458 .6 ± 412 .3)pg/mL (P<0 .05) .The results of linear correlation analysis indicated that plasma NT‐pro BNP was positively correlated with CRP (r= 0 .442 ,P< 0 .05) ,and negatively correlated with Hematocrit ,Albumin and Na (r= -0 .216 ,r= -0 .204 ,r= -0 .315 ,respectively ;P<0 .05) .According to ROC analysis ,the AUC of NT‐pro BNP for detection of KD were 0 .881 ,sensitivity and specificity was 70 .1% and 84 .0% respectively for the cut‐off value of 530 pg/mL .Conclusion Our findings showed that NT‐proBNP would elevate in the acute stage of KD and was a reliable marker for the diagnosis of KD .A high level of NT‐pro BNP is associated with systemic inflammatory responses and increased vascular permeability .