Mir T S, Flato M, Falkenberg J, Haddad M, Budden R, Weil J, Albers S, Laer S
Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany.
Zentrum für Experimentelle Medizin, Institut für Experimentelle und Klinische Pharmakologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany.
Pediatr Cardiol. 2006 Jan-Feb;27(1):73-77. doi: 10.1007/s00246-005-1022-4.
Children with congenital heart disease need adequate diagnostic classification regarding their cardiovascular status (CVS). N-terminal brain natriuretic peptide (N-BNP) plasma concentration indicates dysfunction of the cardiovascular system and guides decisions concerning treatment and prognosis. Reference values are established for adults, with age-dependent increasing values and higher values in women. To avoid misclassification concerning the CVS, a large group of healthy children and adolescents can be used show the relationship between gender, age, and N-BNP and these can serve as reference values. N-BNP was measured in 434 healthy subjects (240 female and 194 male) with ages ranging from 0 to 32 years without any cardiovascular disease or renal or hepatic impairment. Measurements were performed with an electrochemiluminescence immunoassay from Roche Diagnostics. Mean N-BNP decreased from 12.6 fmol/ml (0-9 years; n = 79) to 9.41 fmol/ml (10-14 years; n = 154) and in adolescents from 6.1 (15-19 years; n = 99) to 4.8 fmol/ml (> 19 years; n = 102) in adults (p < 0.05). Mean N-BNP concerning gender did not differ in any age group younger than 19 years. In contrast, the adult female group had 78% higher N-BNP compared to the male group (p < 0.05). There was a significant peak in N-BNP at the age of 12-14 years. This study shows that reference values for N-BNP differed profoundly in children compared to adults and were up to 260% higher in children without any gender difference. Therefore, these reference values will help to avoid CVS misclassification in children for the biomarker N-BNP.
患有先天性心脏病的儿童需要对其心血管状况（CVS）进行充分的诊断分类。N末端脑钠肽（N-BNP）血浆浓度表明心血管系统功能障碍，并指导有关治疗和预后的决策。已为成年人建立了参考值，其值随年龄增加，且女性的值更高。为避免对CVS的错误分类，可以使用一大群健康儿童和青少年来显示性别、年龄与N-BNP之间的关系，这些可作为参考值。对434名年龄在0至32岁之间、无任何心血管疾病或肾或肝损伤的健康受试者（240名女性和194名男性）进行了N-BNP测量。使用罗氏诊断公司的电化学发光免疫分析法进行测量。平均N-BNP从12.6 fmol/ml（0至9岁；n = 79）降至9.41 fmol/ml（10至14岁；n = 154），青少年从6.1（15至19岁；n = 99）降至4.8 fmol/ml（>19岁；n = 102），成年人中（p < 0.05）。在19岁以下的任何年龄组中，按性别划分的平均N-BNP没有差异。相比之下，成年女性组的N-BNP比男性组高78%（p < 0.05）。N-BNP在12至14岁时有一个显著峰值。这项研究表明，与成年人相比，儿童的N-BNP参考值有很大差异，在儿童中高出多达260%，且无性别差异。因此，这些参考值将有助于避免儿童因生物标志物N-BNP而导致的CVS错误分类。
