Isah Isoken A, Sadoh Wilson E, Iduoriyekemwen Nosakhare J
Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria.
Cardiovasc Diagn Ther. 2017 Aug;7(4):380-388. doi: 10.21037/cdt.2017.05.08.
The plasma levels of amino terminal pro-B type natriuretic peptide (NT-proBNP) have been found to be useful in evaluating children with heart failure in developed countries where the cause is mainly structural heart lesions. There is paucity of similar studies from developing countries where the causes are mostly of infectious origin. This article is aim to evaluate the relationship between plasma NT-proBNP levels and the severity, outcome and duration of admission of children with heart failure.
The subjects were children presenting to the children's emergency room (CHER) diagnosed with heart failure based on the modified Ross criteria. The controls were age matched well children recruited from follow up clinics. Information on bio-data and socio-demographics was collected while blood was obtained for plasma NT-proBNP measurement. Data analysis was done with SPSS.
One hundred and twenty six subjects and same number of controls aged 2 months to 13 years were recruited. The mean plasma NT-proBNP in the subjects was 1,137.10±1,243.78 ng/L and in controls, 578.00±665.08 ng/L (t=5.669, P<0.001). Subjects with severe heart failure had a statistically significantly higher mean plasma NT-proBNP than those with mild or moderate categories (P<0.001). A plasma NT-proBNP of 903.15 ng/L had a 73.3% sensitivity and 72.1% specificity for identifying severe heart failure using receiver operating curve (ROC) analysis (95% CI, 0.659-0.912, P<0.001).
Children with heart failure had significantly higher mean NT-proBNP value than controls and the value was highest in those with severe form of heart failure compared to those with moderate or mild categories. Plasma NT-proBNP should be determined for children presenting with clinically diagnosed heart failure to identify those with severe heart failure and institute prompt treatment.
在发达国家，氨基末端B型利钠肽原（NT-proBNP）的血浆水平已被证明有助于评估心力衰竭患儿，这些国家心力衰竭的主要病因是结构性心脏病变。在发展中国家，心力衰竭的病因大多是感染性的，类似的研究较少。本文旨在评估血浆NT-proBNP水平与心力衰竭患儿的严重程度、预后及住院时间之间的关系。
研究对象为根据改良罗斯标准在儿童急诊室（CHER）诊断为心力衰竭的患儿。对照组为从随访诊所招募的年龄匹配的健康儿童。收集生物数据和社会人口统计学信息，同时采集血液用于血浆NT-proBNP测量。使用SPSS进行数据分析。
招募了126名年龄在2个月至13岁之间的研究对象和相同数量的对照组。研究对象的血浆NT-proBNP平均水平为1137.10±1243.78 ng/L，对照组为578.00±665.08 ng/L（t = 5.669，P < 0.001）。重度心力衰竭患儿的血浆NT-proBNP平均水平在统计学上显著高于轻度或中度心力衰竭患儿（P < 0.001）。使用受试者工作特征曲线（ROC）分析，血浆NT-proBNP水平为903.15 ng/L时，识别重度心力衰竭的灵敏度为73.3%，特异度为72.1%（95% CI，0.659 - 0.912，P < 0.001）。
心力衰竭患儿的血浆NT-proBNP平均水平显著高于对照组，与中度或轻度心力衰竭患儿相比，重度心力衰竭患儿的该值最高。对于临床诊断为心力衰竭的患儿，应测定血浆NT-proBNP，以识别重度心力衰竭患儿并及时进行治疗。
