【摘要】：目的：探討和肽素(copeptin)、腦鈉肽(BNP)、C-反應(yīng)蛋白(CRP)在兒童先天性心臟病(CHD)伴心衰患兒外周血濃度的變化及臨床意義。 方法：66例CHD患兒分為心衰組、心衰肺炎組和無心衰組,并設(shè)肺炎對照組和健康對照組。酶聯(lián)免疫吸附法(ELISA)檢測外周血copeptin、BNP和CRP濃度,超聲心動(dòng)圖測定左心室射血分?jǐn)?shù)(LVEF)。 結(jié)果：CHD心衰肺炎組血copeptin、BNP和CRP濃度明顯高于心衰組、無心衰組、肺炎對照組和健康對照組(P0.05或0.01)。CHD心衰患兒外周血copeptin、BNP和CRP濃度高于正常對照組(P0.05或0.01),且隨心衰程度的加重而逐漸升高。CHD心衰患兒血copeptin和BNP濃度與LVEF呈明顯負(fù)相關(guān)(r=-0.602和-0.561,P0.05),CRP與LVEF無明顯相關(guān)性(P0.05)。以外周血copeptin1.92ng/ml和BNP239.50pg/ml為臨界點(diǎn)診斷CHD心衰,其ROC曲線下面積分別為0.822和0.801,特異性分別為87.5%和81.2%,敏感性分別為86.8%和89.5%,Youden指數(shù)(0.743和0.707)比較無差異(U=0.24, p0.05); copeptin和BNP的串聯(lián)試驗(yàn)與平行試驗(yàn)診斷心衰的特異性分別為94%和75%,敏感性分別為79%和95%,Youden指數(shù)分別為0.73和0.7,二者比較無差異(U=0.21,p0.05)。 結(jié)論：CHD心衰患兒外周血copeptin、BNP濃度明顯升高,且與LVEF呈現(xiàn)明顯的負(fù)相關(guān)；外周血copeptin和BNP濃度可作為心衰患兒診斷、嚴(yán)重度及心功能分級的生物學(xué)標(biāo)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，

本文編號(hào)：2495201