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目的观察风湿性心脏病患儿血浆脑利钠肽(BNP)水平的变化,探讨其在风湿热(RF)并心脏病变患儿中的诊断价值。方法选择RF患儿20例(RF组),包括风湿性心脏病患儿11例(心脏病变组),无心脏病变患儿9例(无心脏病变组)。同时选择20例健康儿童作为健康对照组。采用ELISA测定各组血浆BNP、肌钙蛋白I(cTnI)水平,并行心脏彩色多普勒超声及ECG检查。健康对照组随机采血1次,测定血浆BNP和cTnI水平。应用SPSS 11.5软件进行统计学分析。结果 RF组患儿血浆BNP、cTnI水平均明显高于健康对照组(Pa<0.01);心脏病变组血浆BNP水平较无心脏病变组明显升高(P<0.01),cTnI水平二组比较差异亦有统计学意义(P<0.05);BNP异常升高率显著高于cTnI(χ2=14.19,P<0.01)及ECG(χ2=10.23,P<0.01),cTnI异常率与ECG异常率比较差异无统计学意义(χ2=1.37,P>0.05)。心脏病变组患儿BNP与cTnI水平呈显著正相关(r=0.32,P<0.05)。结论BNP在风湿性心脏病患儿中异常增高,与cTnI呈正相关,且较cTnI、ECG灵敏度高。BNP、cTnI二者结合对RF并心脏病变的诊断具有重要意义。
Objective To observe the changes of plasma brain natriuretic peptide (BNP) levels in children with rheumatic heart disease (CHD) and investigate the diagnostic value of BNP in children with rheumatic fever (RF) and heart disease. METHODS: Twenty children with RF were enrolled in this study, including 11 children with rheumatic heart disease (heart disease group) and 9 children without heart disease (without heart disease group). At the same time, 20 healthy children were selected as healthy control group. Plasma BNP and troponin I (cTnI) levels were measured by ELISA. Cardiac color Doppler echocardiography and ECG were performed. The healthy control group were randomly divided into two groups: blood plasma BNP and cTnI levels. SPSS 11.5 software was used for statistical analysis. Results The plasma levels of BNP and cTnI in children with RF were significantly higher than those in healthy controls (P <0.01). The levels of plasma BNP in patients with cardiac disease were significantly higher than those without cardiac disease (P <0.01) (Χ2 = 14.19, P <0.01) and ECG (χ2 = 10.23, P <0.01). There was no significant difference between cTnI abnormal rate and ECG abnormality rate Statistical significance (χ2 = 1.37, P> 0.05). There was a significant positive correlation between BNP and cTnI in children with heart disease (r = 0.32, P <0.05). Conclusions BNP is abnormally elevated in children with rheumatic heart disease, positively correlated with cTnI, and higher than cTnI and ECG. The combination of BNP and cTnI is of great significance for the diagnosis of RF and heart disease.