Schwachtgen L, Herrmann M, Georg T, Schwarz P, Marx N, Lindinger A
Derpartment of Pediatric Cardiology, University of the Saarland, Homburg/Saar, Germany.
Z Kardiol. 2005 Jun;94(6):399-404. doi: 10.1007/s00392-005-0246-x.
N-terminal brain natriuretic peptide (NT-proBNP) is a neurohormonal substance secreted mainly by the cardiac myocytes of the left ventricle and to a less degree of the left atrium. The releasing mechanism is induced by an increased wall stress on the base of volume or pressure load of the ventricle. The physiologic actions of BNP are prohibition of the sympathetic activity, vasodilatation, natriuresis, diureses and inhibition of the renin-angiotensin system. Because of its high sensitivity and specifity in relation to the left ventricular incompetence, BNP as well as NTproBNP are well accepted markers of ventricular dysfunction. It was the aim of the study to establish reference values of NT-proBNP serum concentrations throughout childhood, in particular in the newborn age group.
In a cross sectional study, serum NT-proBNP concentrations were measured by an ElectroChemiLuminescenceImmunoAssay ("ECLIA" Roche) in the umbilical cord blood of 62 healthy full-term neonates and in 222 healthy probands from birth up to the age of 18 years.
The concentration of NT-proBNP in the cord blood samples ranged from 281 to 2595 pg/ml (mean: 818 pg/ml). There was a significant increase in the first days of life followed by a rapid decrease during the first year and a further gradual decrease throughout infancy; beyond the 10(th) year of age normal adult values were approached.
The knowledge of the normal range of plasma NT-proBNP levels in healthy subjects during childhood serves as a non-invasive marker for differentiation of pathologic conditions such as acute myocarditis, hypertrophic or dilated cardiomyopathy, tachyarrhythmias and pulmonary hypertension.
N 末端脑钠肽（NT-proBNP）是一种主要由左心室心肌细胞分泌的神经激素物质，左心房分泌较少。其释放机制是在心室容量或压力负荷增加导致壁应力升高的基础上诱发的。BNP 的生理作用包括抑制交感神经活动、血管舒张、利钠、利尿以及抑制肾素 - 血管紧张素系统。由于其对左心室功能不全具有高敏感性和特异性，BNP 以及 NT-proBNP 都是被广泛认可的心室功能障碍标志物。本研究的目的是确定整个儿童期，特别是新生儿年龄组 NT-proBNP 血清浓度的参考值。
在一项横断面研究中，采用电化学发光免疫分析法（“ECLIA”，罗氏公司）测定了 62 例健康足月新生儿脐带血以及 222 例从出生至 18 岁健康受试者的血清 NT-proBNP 浓度。
脐带血样本中 NT-proBNP 的浓度范围为 281 至 2595 pg/ml（平均：818 pg/ml）。出生后第一天浓度显著升高，随后在第一年迅速下降，在整个婴儿期进一步逐渐下降；10 岁以后接近正常成人水平。
了解健康儿童血浆 NT-proBNP 水平的正常范围可作为一种非侵入性标志物，用于鉴别诸如急性心肌炎、肥厚型或扩张型心肌病、快速性心律失常和肺动脉高压等病理状况。
