da Graca Ralph L, Hassinger Denise C, Flynn Patrick A, Sison Cristina P, Nesin Mirjana, Auld Peter A M
Department of Pediatrics, New York Presbyterian Hospital, Weill Medical College, Cornell University, New York, New York, USA.
Pediatrics. 2006 Jun;117(6):2183-9. doi: 10.1542/peds.2005-1387.
To determine age-related concentrations of brain-type natriuretic peptide in preterm infants using bedside Triage brain-type natriuretic peptide test and correlate it to the presence or absence of the patent ductus arteriosus and ventilatory support.
Serum brain-type natriuretic peptide levels were measured in infants who were born at <32 weeks' gestation from birth to 2 months of age. Serial echocardiograms were performed, until closure of the patent ductus arteriosus, or until discharge. Brain-type natriuretic peptide levels were correlated to the day of life, gestational age, presence or absence of the patent ductus arteriosus, and the degree of ventilatory support. Nineteen preterm infants (gestational age: 24-31 weeks; birth weight: 645-1670 g) were enrolled prospectively during the first 2 weeks of life. Serum brain-type natriuretic peptide levels (pg/mL) were determined in 177 blood samples, and 87 paired echocardiograms were performed.
Significant negative correlation was found between brain-type natriuretic peptide levels and the day of life and remained significant when the patients were stratified by gestational age (< or =28 weeks and >28 weeks). Higher brain-type natriuretic peptide levels correlated with increasing grade of the patent ductus arteriosus. Significant differences in brain-type natriuretic peptide levels were seen with increasing ventilatory support. Comparisons between the size of patent ductus arteriosus and the degree of ventilatory support to brain-type natriuretic peptide levels revealed that the size of the patent ductus arteriosus was the major determinant of both brain-type natriuretic peptide levels and the degree of ventilatory support.
Similar to term infants, brain-type natriuretic peptide levels of preterm infants are related to the chronological age and decline during the first month of life. Rapid bedside Triage brain-type natriuretic peptide is a potentially valuable and practical assay in determining the hemodynamic changes in preterm infants.
使用床旁快速检测脑钠肽试验测定早产儿脑钠肽的年龄相关浓度，并将其与动脉导管未闭的存在与否及通气支持情况相关联。
对孕周小于32周的婴儿从出生至2月龄测定其血清脑钠肽水平。进行系列超声心动图检查，直至动脉导管未闭闭合或直至出院。脑钠肽水平与出生天数、孕周、动脉导管未闭的存在与否以及通气支持程度相关。19例早产儿（孕周：24 - 31周；出生体重：645 - 1670克）在出生后前2周前瞻性入组。测定了177份血样中的血清脑钠肽水平（pg/mL），并进行了87次配对超声心动图检查。
脑钠肽水平与出生天数之间存在显著负相关，当按孕周（≤28周和＞28周）分层时该相关性仍显著。较高的脑钠肽水平与动脉导管未闭分级增加相关。随着通气支持程度增加，脑钠肽水平存在显著差异。动脉导管未闭大小和通气支持程度与脑钠肽水平的比较显示，动脉导管未闭大小是脑钠肽水平和通气支持程度的主要决定因素。
与足月儿相似，早产儿脑钠肽水平与实际年龄相关且在出生后第一个月内下降。床旁快速检测脑钠肽在确定早产儿血流动力学变化方面是一种潜在有价值且实用的检测方法。
