Department of Paediatrics, Children's Hospital, London Health Science Centre, University of Western Ontario, 800 Commissioners Road East, London, ON N6A 5W9, Canada.
Clin Res Cardiol. 2011 Sep;100(9):723-30. doi: 10.1007/s00392-011-0317-0. Epub 2011 Apr 14.
Serum concentrations of N-terminal natriuretic pro-brain natriuretic peptide (NT-proBNP) correlate well with the severity of cardiac disease in children and adults. There are also paediatric illnesses of extracardiac origin that may cause deterioration of the cardiac function in some patients (pts). A high NP level can signify a concomitant cardiac involvement in respiratory distress, or secondary to a systemic disease.
To assess the potential of NT-proBNP as a screening tool for cardiac involvement in paediatric diseases of extracardiac origin.
A literature search was performed in PubMed for the relevant studies with the subject brain natriuretic peptide (BNP) and NT-proBNP from 1995 to 2010 with stress on characteristics of the natriuretic peptides, paediatric reference values and systemic paediatric diseases with potential influence on the myocardial performance. The main focus has been NT-proBNP being the most stable NP and correlating well with BNP.
Most studies agree that a high NT-proBNP level indicates cardiac dysfunction in different systemic diseases such as thalassemia and cystic fibrosis or in pts after chemotherapy. In special clinical scenarios as sepsis or respiratory distress, NT-proBNP helps to narrow down the differential diagnosis or can be used for risk stratification.
NT-proBNP can serve as a screening tool in various primarily non-cardiac paediatric diseases. Together with the clinical picture, a high level suggests further assessment by a paediatric cardiologist.
血清 N 端脑利钠肽前体（NT-proBNP）浓度与儿童和成人心脏病的严重程度密切相关。也有一些起源于心脏外的儿科疾病可能导致某些患者的心脏功能恶化（pts）。高 NP 水平可能表示在呼吸窘迫中伴有心脏受累，或者继发于全身性疾病。
评估 NT-proBNP 作为儿科心脏外疾病中心脏受累的筛查工具的潜力。
在 PubMed 上进行了文献检索，检索了 1995 年至 2010 年与脑利钠肽（BNP）和 NT-proBNP 相关的研究，重点关注利钠肽的特征、儿科参考值以及可能影响心肌功能的全身性儿科疾病。主要重点是 NT-proBNP 是最稳定的 NP，与 BNP 相关性良好。
大多数研究都认为，高 NT-proBNP 水平表明不同的全身性疾病（如地中海贫血和囊性纤维化）或化疗后的患者存在心脏功能障碍。在特殊的临床情况下，如脓毒症或呼吸窘迫，NT-proBNP 有助于缩小鉴别诊断范围，或可用于风险分层。
NT-proBNP 可作为各种主要非心脏儿科疾病的筛查工具。结合临床表现，高水平提示需要由儿科心脏病专家进一步评估。
