尼日利亚拉各斯一家三级医院中N末端脑钠肽前体在心力衰竭患儿中的诊断效用

Diagnostic usefulness of N-terminal pro-brain natriuretic peptide among children with heart failure in a tertiary hospital in Lagos, Nigeria.

作者信息

Ekure E N, Okoromah C A, Ajuluchukwu J N, Mbakwem A, Oladipo O O

机构信息

Departments of Paediatrics, Medicine, Chemical Pathology, College of Medicine, University of Lagos, Nigeria.

出版信息

West Afr J Med. 2011 Jan-Feb;30(1):29-34. doi: 10.4314/wajm.v30i1.69881.

DOI:10.4314/wajm.v30i1.69881

PMID:21863586

Abstract

BACKGROUND

N-terminal pro-brain natriuretic peptide (NTproBNP) is useful in the diagnosis and management of adult patients with heart failure.

OBJECTIVE

The objective of the study was to determine the usefulness of NT-proBNP in diagnosing congestive heart failure (CHF) in children and its correlation with left ventricular ejection fraction (LVEF) and clinical heart failure score.

METHODS

Plasma NT-proBNP was measured in 28 children with CHF and age matched controls. Heart failure assessment was done using modified Ross score and all had echocardiography done.

RESULTS

Mean plasma NT-proBNP of children with CHF (377.86±1026.49pg/mL) was significantly higher than that of controls (353.61±328.50 pg/mL) (p<0.001). A plasma NT-pro BNP of 951pg/mL was used as the cut off value for heart failure. The sensitivity, specificity, negative and positive predictive values were 57%, 96%, 69% and 94% respectively. NT-pro BNP levels showed a high positive correlation with the modified Ross score (r= 0.502; p<0.001) but low correlation with LVEF (r= -0.137; p>0.3).

CONCLUSION

Our findings indicate that measuring NT-pro BNP may be useful as a diagnostic tool in congestive cardiac failure in children. The fact that its levels also correlated positively with modified Ross score thereby objectively determining severity of heart failure suggests that this biomarker may also be useful as an evaluation tool in congestive cardiac failure in children.

摘要

背景

N 末端脑钠肽前体（NTproBNP）在成年心力衰竭患者的诊断和管理中很有用。

目的

本研究的目的是确定 NT-proBNP 在诊断儿童充血性心力衰竭（CHF）中的作用及其与左心室射血分数（LVEF）和临床心力衰竭评分的相关性。

方法

对 28 例 CHF 患儿和年龄匹配的对照组进行血浆 NT-proBNP 检测。使用改良罗斯评分进行心力衰竭评估，所有患儿均进行了超声心动图检查。

结果

CHF 患儿的平均血浆 NT-proBNP（377.86±1026.49pg/mL）显著高于对照组（353.61±328.50 pg/mL）（p<0.001）。血浆 NT-proBNP 951pg/mL 被用作心力衰竭的临界值。敏感性、特异性、阴性和阳性预测值分别为 57%、96%、69%和 94%。NT-proBNP 水平与改良罗斯评分呈高度正相关（r = 0.502；p<0.001），但与 LVEF 相关性较低（r = -0.137；p>0.3）。