CAJ | 학술논문

目的：探讨和肽素和脑利钠肽（BNP）在小儿急性心力衰竭（AHF）中的变化水平及临床意义。方法选择57例A H F患儿作为研究对象，其中肺炎合并心衰35例，先天性心脏病合并心衰22例；同时选择35例健康儿童作为健康对照组、30例肺炎无心力衰竭患儿作为肺炎对照组。比较各组血浆和肽素、BNP水平及与心功能参数的相关性。结果 AHF组、肺炎合并心衰组、先天性心脏病合并心衰组血浆和肽素、BNP水平显著高于肺炎对照组和健康对照组，差异有统计学意义（P＜0．05）；其中AHF组、肺炎合并心衰组、先天性心脏病合并心衰组患儿心衰期血浆和肽素、BNP水平又明显高于恢复期，差异有统计学意义（P＜0．05）。心衰中度组和重度组患儿血浆和肽素、BNP水平显著高于轻度组，其中重度组又高于中度组（P＜0．05）。相关性分析显示心衰期血浆和肽素、BNP水平与左心室射血分数（LVEF）、心指数（CI）呈负相关关系（P＜0．05），而恢复期血浆和肽素、BNP水平与左心房射血分数（LVEF）、心指数（CI）无明显相关性（P＞0．05）。结论和肽素、BNP对小儿AHF的早期诊断、病情评估、治疗指导和预后有着重要意义。
목적：탐토화태소화뇌리납태（BNP）재소인급성심력쇠갈（AHF）중적변화수평급림상의의。방법선택57례A H F환인작위연구대상，기중폐염합병심쇠35례，선천성심장병합병심쇠22례；동시선택35례건강인동작위건강대조조、30례폐염무심력쇠갈환인작위폐염대조조。비교각조혈장화태소、BNP수평급여심공능삼수적상관성。결과 AHF조、폐염합병심쇠조、선천성심장병합병심쇠조혈장화태소、BNP수평현저고우폐염대조조화건강대조조，차이유통계학의의（P＜0．05）；기중AHF조、폐염합병심쇠조、선천성심장병합병심쇠조환인심쇠기혈장화태소、BNP수평우명현고우회복기，차이유통계학의의（P＜0．05）。심쇠중도조화중도조환인혈장화태소、BNP수평현저고우경도조，기중중도조우고우중도조（P＜0．05）。상관성분석현시심쇠기혈장화태소、BNP수평여좌심실사혈분수（LVEF）、심지수（CI）정부상관관계（P＜0．05），이회복기혈장화태소、BNP수평여좌심방사혈분수（LVEF）、심지수（CI）무명현상관성（P＞0．05）。결론화태소、BNP대소인AHF적조기진단、병정평고、치료지도화예후유착중요의의。
Objective To explore the changes and clinical value of brain natriuretic peptide (BNP) and copeptin levels in child acute heart failure(AHF) .Methods 57 children patients with AHF in our hospital were selected as the research subjects ,including 35 cases of pneumonia complicating AHF and 22 case of congenital heart disease (CHD) complicating AHF ;at the same time ,35 healthy children were selected as the healthy control group and 30 cases of pneumonia in children with pneumonia without power failure as control group .The plasma levels of copeptin and BNP were compared among various groups ,and their correlations with cardiac function parameters were also compared .Results The plasma copeptin and BNP levels in the AHF group ,pneumonia complicating AHF group and CHD complicating AHF group were significantly higher than those in the pneumonia control group and the healthy control group ,the differences were statistically significant (P<0 .05);in which ,the plasma copeptin and BNP levels during AHF stage in the AHF group ,pneumonia complicating AHF group and CHD complicating AHF group were significantly higher than those in the recovery stage ,the differences were statistically significant (P<0 .05) .the plas‐ma copeptin and BNP levels in the moderate AHF group and the severe AHF group were significantly higher than those in the mild AHF group ,while the severe AHF group was higher than the moderate AHF group (P<0 .05) .The correlation analysis showed that plasma copeptin and BNP levels during the AHF stage were negatively correlated with LVEF and CI(P<0 .05) ,while plasma copeptin and BNP levels during the recovery stage had no obvious corre‐lation with LVEF and CI(P>0 .05) .Conclusion Copeptin and BNP have important significance for the early diagno‐sis ,condition evaluation ,treatment guidance and prognosis in child AHF .