和肽素、脑钠肽和C-反应蛋白在小儿先天性心脏病合并心力衰竭外周血浓度的变化及临床意义

发布时间：2019-06-08 09:57

【摘要】：目的：探讨和肽素(copeptin)、脑钠肽(BNP)、C-反应蛋白(CRP)在儿童先天性心脏病(CHD)伴心衰患儿外周血浓度的变化及临床意义。 方法：66例CHD患儿分为心衰组、心衰肺炎组和无心衰组,并设肺炎对照组和健康对照组。酶联免疫吸附法(ELISA)检测外周血copeptin、BNP和CRP浓度,超声心动图测定左心室射血分数(LVEF)。 结果：CHD心衰肺炎组血copeptin、BNP和CRP浓度明显高于心衰组、无心衰组、肺炎对照组和健康对照组(P0.05或0.01)。CHD心衰患儿外周血copeptin、BNP和CRP浓度高于正常对照组(P0.05或0.01),且随心衰程度的加重而逐渐升高。CHD心衰患儿血copeptin和BNP浓度与LVEF呈明显负相关(r=-0.602和-0.561,P0.05),CRP与LVEF无明显相关性(P0.05)。以外周血copeptin1.92ng/ml和BNP239.50pg/ml为临界点诊断CHD心衰,其ROC曲线下面积分别为0.822和0.801,特异性分别为87.5%和81.2%,敏感性分别为86.8%和89.5%,Youden指数(0.743和0.707)比较无差异(U=0.24, p0.05); copeptin和BNP的串联试验与平行试验诊断心衰的特异性分别为94%和75%,敏感性分别为79%和95%,Youden指数分别为0.73和0.7,二者比较无差异(U=0.21,p0.05)。 结论：CHD心衰患儿外周血copeptin、BNP浓度明显升高,且与LVEF呈现明显的负相关；外周血copeptin和BNP浓度可作为心衰患儿诊断、严重度及心功能分级的生物学标志物。
[Abstract]:Aim: to investigate the changes and clinical significance of (copeptin), brain natriuretic peptide (BNP), C-reactive protein (CRP) in peripheral blood of children with congenital heart disease (CHD) with heart failure. Methods: 66 children with CHD were divided into three groups: heart failure group, heart failure pneumonia group and no heart failure group, and divided into pneumonia control group and healthy control group. The concentrations of copeptin,BNP and CRP in peripheral blood were measured by enzyme-linked immunosorbent assay (Elisa), and the left ventricular ejection fraction (LVEF).) was measured by echocardiography. Results: the concentrations of copeptin,BNP and CRP in CHD heart failure pneumonia group were significantly higher than those in heart failure group, no heart failure group, pneumonia control group and healthy control group (P 0.05 or 0.01). CHD). The concentrations of BNP and CRP were higher than those in the normal control group (P 0.05 or 0.001), and increased gradually with the aggravation of heart failure. There was a significant negative correlation between blood copeptin and BNP concentrations and LVEF in children with coronary heart failure (r 鈮，

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