CAJ | 학술논문

目的：探讨血清N末端B型脑钠肽前体（ NT-proBNP）检测在新生儿心源性与非心源性呼吸困难诊断及鉴别诊断中的应用。方法选择2013年1月至2014年2月宝鸡市中心医院小儿科收治的以呼吸困难为主要症状的新生儿患者128例，根据病因不同分为心源性呼吸困难（心源性组）56例，非心源性呼吸困难（非心源性组）72例，同时选择健康新生儿40例作为对照组。依据改良ROSS新生儿心功能分级标准，将心源性组患儿分为心功能Ⅰ级31例、Ⅱ级18例、Ⅲ级7例，采用心脏超声检测患儿左心室射血分数（LVEF）。采用电化学发光法检测血清 NT-proBNP的水平并进行组间比较。结果心源性组血清NT-proBNP水平为（4922±1244） ng／L，非心源性组为（314±47） ng／L，对照组为（58±22） ng／L，心源性组和非心源性组高于对照组，心源性组高于非心源性组，差异均有统计学意义（P＜0.05）。随着患儿新功能分级的升高，血清 NT-proBNP水平逐渐增高，差异有统计学意义（P＜0.05），血清 NT-proBNP 水平与 LVEF 呈负相关（r ＝－0.564，P ＜0.05）。结论血清NT-proBNP水平检测在新生儿心源性与非心源性急性呼吸困难的诊断及鉴别诊断中具有重要的临床意义。
목적：탐토혈청N말단B형뇌납태전체（ NT-proBNP）검측재신생인심원성여비심원성호흡곤난진단급감별진단중적응용。방법선택2013년1월지2014년2월보계시중심의원소인과수치적이호흡곤난위주요증상적신생인환자128례，근거병인불동분위심원성호흡곤난（심원성조）56례，비심원성호흡곤난（비심원성조）72례，동시선택건강신생인40례작위대조조。의거개량ROSS신생인심공능분급표준，장심원성조환인분위심공능Ⅰ급31례、Ⅱ급18례、Ⅲ급7례，채용심장초성검측환인좌심실사혈분수（LVEF）。채용전화학발광법검측혈청 NT-proBNP적수평병진행조간비교。결과심원성조혈청NT-proBNP수평위（4922±1244） ng／L，비심원성조위（314±47） ng／L，대조조위（58±22） ng／L，심원성조화비심원성조고우대조조，심원성조고우비심원성조，차이균유통계학의의（P＜0.05）。수착환인신공능분급적승고，혈청 NT-proBNP수평축점증고，차이유통계학의의（P＜0.05），혈청 NT-proBNP 수평여 LVEF 정부상관（r ＝－0.564，P ＜0.05）。결론혈청NT-proBNP수평검측재신생인심원성여비심원성급성호흡곤난적진단급감별진단중구유중요적림상의의。
Objective To investigate the diagnosis value and differential diagnosis value of serum N-ter-minal pro-brain natriuretic peptide ( NT-proBNP) on neonatal cardiac dyspnea and noncardiac dyspnea. Methods Total of 128 neonates with acute dyspnea from Baoji Central Hospital during Jan.2013 and Feb. 2014 were chosen,according to the cause of dyspnea,they were divided into cardiac dyspnea(cardiac group, n=56) and noncardiac dyspnea (noncardiac group,n =72),and another 40 healthy neonates during the same period were selected as control group.The cardiac dyspnea neonates were classified into classⅠ(31 cases),Ⅱ(18 cases) and Ⅲ(7 cases) according to ROSS classification and left ventricular ejection fraction ( LVEF) was measured by cardiac ultrasonography.The levels of serum NT-proBNP were detected by automated electrochemical luminescence and compared between the groups.Results The level of serum NT-proBNP in the cardiac group was (4922 ±1244) ng/L,in the noncardiac group was (314 ±47) ng/L,in the control group was (58 ±22) ng/L,the differences were statistically significant(P <0.05).With the upgrade of cardiac function classification increasing,the levels of serum NT-proBNP increased with significant difference(P<0.05).The levels of serum NT-proBNP had a negative correlation with LVEF(r=-0.564, P<0.05).Conlusion Detection of serum NT-proBNP has a great clinical significance to the diagnosis and differential diagnosis of cardiac dyspnea and noncardiac dyspnea in neonates.