Smith Julie, Goetze Jens P, Andersen Claus B, Vejlstrup Niels
Department of Pathology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Cardiol Young. 2010 Aug;20(4):353-63. doi: 10.1017/S1047951110000211. Epub 2010 May 11.
It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional diagnostic tools. Natriuretic peptide measurements could be that extra tool. We discuss and suggest N-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide reference intervals for children without cardiovascular disease and cut-off points for the four specific paediatric heart conditions. We conclude that in premature neonates with persistent arterial ducts; in teenagers with tetralogy of Fallot and pulmonary regurgitation; and in children with heart transplants and potential allograft rejection cardiac peptides can provide the clinician with additional information, but in children with atrial septal defects the peptides are not helpful in guiding treatment or follow-up.
心脏利钠肽是否为儿科心脏病学中有用的生物标志物仍不确定。在本综述中，我们确定了儿科心脏病学中的四种临床情况，在这些情况下临床决策可能会很困难，并且我们认为儿科心脏病专家需要额外的诊断工具。利钠肽测量可能就是那个额外的工具。我们讨论并建议了无心血管疾病儿童的N末端B型利钠肽原和B型利钠肽参考区间，以及四种特定儿科心脏疾病的截断点。我们得出结论，在患有持续性动脉导管未闭的早产儿中；在患有法洛四联症和肺动脉反流的青少年中；以及在接受心脏移植且有潜在同种异体移植排斥反应的儿童中，心脏肽可为临床医生提供额外信息，但在患有房间隔缺损的儿童中，这些肽对指导治疗或随访并无帮助。
