Zhang Zhi-Ling, Lin Li-Xing, An Cai-Xia, Tao Zhong-Bin, Yang Mei
Department of Pediatrics, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2009 Dec;11(12):973-5.
To investigate the changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) in neonates with hypoxic-ischemic encephalopathy (HIE) complicated by myocardial ischemic injury.
Thirty-five neonates with HIE (17 cases with concurrent myocardial injury and 18 cases without) were enrolled. Twenty healthy neonates were used as the control group. Plasma NT-proBNP levels were measured using enzyme immunoassay.
The mean plasma NT-proBNP levels in patients with myocardial injury (338.8 + or - 76.2 fmol/mL) were significantly higher than those in patients with non-myocardial injury (137.5 + or - 45.1 fmol/mL) and in the control group (113.7 + or - 53.6 fmol/mL) (p<0.01). The NT-proBNP levels in mild, moderate and severe HIE neonates were 141.3 + or - 41.6, 271.8 + or - 118.1 and 347.2 + or - 85.1 fmol/mL, respectively. Compared with the control group, the NT-proBNP levels in the moderate and the severe HIE groups significantly increased (p<0.01). There were significant differences in the NT-proBNP level among the mild, moderate and severe HIE groups (p<0.05). In patients with myocardial injury, the NT-proBNP levels significantly decreased in the convalescent phase compared with those in the acute phase (225.0 + or - 80.0 fmol/mL vs 338.8 + or - 76.2 fmol/mL (p<0.01).
Plasma NT-proBNP levels increase in neonates with HIE complicated by myocardial ischemic injury in the acute phase. Detection of NT-proBNP levels may be useful in the diagnosis of myocardial ischemic injury and the severity evaluation of HIE.
探讨缺氧缺血性脑病（HIE）合并心肌缺血损伤新生儿N末端脑钠肽前体（NT-proBNP）的变化。
纳入35例HIE新生儿（其中17例并发心肌损伤，18例未并发）。选取20例健康新生儿作为对照组。采用酶免疫法测定血浆NT-proBNP水平。
心肌损伤患者的平均血浆NT-proBNP水平（338.8±76.2 fmol/mL）显著高于非心肌损伤患者（137.5±45.1 fmol/mL）和对照组（113.7±53.6 fmol/mL）（p<0.01）。轻度、中度和重度HIE新生儿的NT-proBNP水平分别为141.3±41.6、271.8±118.1和347.2±85.1 fmol/mL。与对照组相比，中度和重度HIE组的NT-proBNP水平显著升高（p<0.01）。轻度、中度和重度HIE组之间的NT-proBNP水平存在显著差异（p<0.05）。在心肌损伤患者中，恢复期的NT-proBNP水平与急性期相比显著降低（225.0±80.0 fmol/mL对338.8±76.2 fmol/mL，p<0.01）。
HIE合并心肌缺血损伤的新生儿急性期血浆NT-proBNP水平升高。检测NT-proBNP水平可能有助于心肌缺血损伤的诊断及HIE严重程度的评估。
