急性与慢性左心室功能障碍时N末端B型利钠肽原水平
N-terminal pro-B-type natriuretic peptide levels in acute versus chronic left ventricular dysfunction.
作者信息
Fried Iris, Bar-Oz Benjamin, Perles Zeev, Rein Azaria J J T, Zonis Zeev, Nir Amiram
机构信息
Department of Pediatrics, Hadassah-The Hebrew University Medical Center, Jerusalem, Israel.
出版信息
J Pediatr. 2006 Jul;149(1):28-31. doi: 10.1016/j.jpeds.2006.02.038.
OBJECTIVES
To determine whether acute left ventricular dysfunction (LVD) causes significantly higher elevation of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels than comparable chronic LVD.
STUDY DESIGN
Plasma levels of NT-proBNP were measured in 10 pediatric patients diagnosed with acute LVD, in 7 pediatric patients with stable chronic dilated cardiomyopathy (DCM) and comparable levels of echocardiographic dysfunction, and during 5 episodes of acute exacerbation in patients with heart failure. Levels were compared using Mann-Whitney and analysis of variance for rank tests.
RESULTS
Plasma levels of NT-proBNP were excessively elevated in patients with acute LVD in the first 24 to 48 hours of hospitalization (median level, 65,600 pg/mL), and were significantly higher than those in patients with chronic DCM (median level, 1125 pg/mL; P < .0001). NT-proBNP levels decreased in the subsequent days in 83% of patients with serial measurements. The NT-proBNP levels were lower In 5 episodes of acute exacerbation than in acute LVD (median level, 7185 pg/mL; P < .003).
CONCLUSIONS
Acute LVD is associated with elevated NT-proBNP level in children.
目的
确定急性左心室功能障碍（LVD）是否比类似的慢性LVD导致N末端B型脑钠肽原（NT-proBNP）水平显著更高的升高。
研究设计
对10例诊断为急性LVD的儿科患者、7例患有稳定慢性扩张型心肌病（DCM）且超声心动图功能障碍水平相当的儿科患者以及心力衰竭患者的5次急性加重发作期间的NT-proBNP血浆水平进行了测量。使用Mann-Whitney检验和秩和检验进行水平比较。
结果
急性LVD患者在住院的最初24至48小时内NT-proBNP血浆水平过度升高（中位数水平为65,600 pg/mL），且显著高于慢性DCM患者（中位数水平为1125 pg/mL；P <.0001）。在进行连续测量的患者中，83%在随后几天NT-proBNP水平下降。5次急性加重发作时的NT-proBNP水平低于急性LVD时（中位数水平为7185 pg/mL；P <.003）。
结论
急性LVD与儿童NT-proBNP水平升高有关。
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