Liu Fang, Luo Xiaoli, Chen Xiuqi, Lu Zhenhao, Wei Dan, Yang Zhiyong
Department of Pediatrics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Department of Pediatric Critical Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Transl Pediatr. 2021 May;10(5):1355-1360. doi: 10.21037/tp-21-123.
N-terminal brain natriuretic peptide precursor (NT-proBNP) and brain natriuretic peptide (BNP) are mainly produced and secreted in the heart. In 2008, the European Heart Association recommended that serum BNP/NT-proBNP levels should be included in one of the diagnostic criteria of heart failure. Serum NT-proBNP is more stable than BNP, and the detection results are less affected by objective factors, so it is widely used. At present, NT-proBNP has long been beyond the scope of heart failure markers, and has a wide range of clinical value in the evaluation and prediction of some serious diseases. This study prospectively studied the predictive value of serum NT-proBNP in pediatric intensive care unit (PICU).
This was a prospective study involving 375 children in the PICU. The patients were divided into three groups: non-risk, low-risk, and high-risk groups. Serum NT-proBNP levels and the 28-day mortality rate were analyzed.
The serum NT-proBNP levels and the mortality of the high-risk group was significantly higher than those of the low- and non-risk groups (P<0.01 in both cases). Receiver operating characteristic curve (ROC curve) analysis showed that the area under the curve was 0.705 (P<0.001, sensitivity =0.643, specificity =0.692). Death multivariate binary logistic regression analysis indicated that NT-proBNP was not an independent factor for 28-day mortality.
Serum NT-proBNP was significantly correlated with the severity of illness for critically ill patients in PICU. Although high levels of NT-proBNP indicated greater severity, this was not an independent risk factor affecting the prognosis of patients.
N 末端脑钠肽前体（NT-proBNP）和脑钠肽（BNP）主要在心脏产生和分泌。2008 年，欧洲心脏病协会建议将血清 BNP/NT-proBNP 水平纳入心力衰竭的诊断标准之一。血清 NT-proBNP 比 BNP 更稳定，检测结果受客观因素影响较小，因此被广泛应用。目前，NT-proBNP 早已超出心力衰竭标志物的范畴，在一些严重疾病的评估和预测中具有广泛的临床价值。本研究前瞻性地探讨了血清 NT-proBNP 在儿科重症监护病房（PICU）中的预测价值。
这是一项对 PICU 中 375 名儿童进行的前瞻性研究。患者被分为三组：非风险组、低风险组和高风险组。分析血清 NT-proBNP 水平和 28 天死亡率。
高风险组的血清 NT-proBNP 水平和死亡率显著高于低风险组和非风险组（两者 P<0.01）。受试者操作特征曲线（ROC 曲线）分析显示曲线下面积为 0.705（P<0.001，敏感性 =0.643，特异性 =0.692）。死亡多因素二元逻辑回归分析表明，NT-proBNP 不是 28 天死亡率的独立因素。
血清 NT-proBNP 与 PICU 中危重症患者的疾病严重程度显著相关。虽然 NT-proBNP 水平高表明病情更严重，但这不是影响患者预后的独立危险因素。
