摘要
目的探讨N端脑钠肽前体(NT-proBNP)联合心肌肌钙蛋白T(cTnT)在评估肺炎合并心力衰竭(心衰)新生儿的心肌损害程度及预后的价值。方法选取2017年9月至2021年9月长江大学附属仙桃市第一人民医院收治的94例肺炎合并心衰新生儿作为心衰组,根据Ross评分将其分为轻度组(n=36)、中度组(n=33)和重度组(n=25),根据预后情况分为预后良好组(n=71)和预后不良组(n=23)。另选取同期收治的38例单纯肺炎新生儿作为肺炎组。比较各组患儿血清NT-proBNP、cTnT水平变化,采用受试者工作特征曲线分析血清NT-proBNP、cTnT及其联合检测评估肺炎合并心衰患儿不良预后的价值。结果心衰组患儿血清NT-proBNP水平为(646.56±43.28)pg/mL、cTnT水平为(0.43±0.08)ng/mL,均高于肺炎组,差异有统计学意义(P<0.001)。重度组患儿血清NTproBNP、cTnT水平高于轻度组、中度组,中度组患儿血清NT-proBNP、cTnT水平高于轻度组,差异均有统计学意义(P<0.05)。预后不良组心衰患儿血清NT-proBNP水平为(668.98±39.84)pg/mL、cTnT水平为(0.55±0.15)ng/mL,均高于预后良好组,差异均有统计学意义(P<0.05);血清NT-proBNP、cTnT及其联合检测对心衰不良预后的曲线下面积分别为0.819、0.829和0.930,联合检测的AUC高于其单独检测(P<0.05)。结论血清NT-proBNP、cTnT水平与肺炎合并心衰患儿心衰严重程度相关,二者联合检测可提高肺炎合并心衰患儿不良预后预测价值。
Objective To explore the value of N-terminal pro-brain natriuretic peptide(NT-proBNP)combined with cardiac troponin T(cTnT)in evaluating the severity of myocardial damage and prognosis of neonates with pneumonia and heart failure(HF).Methods A total of 94 neonates with pneumonia and HF admitted to Xiantao First People’s Hospital Affiliated to Yangtze University were enrolled as HF group be⁃tween September 2017 and September 2021.According to Ross scores,they were divided into mild group(36 cases),moderate group(33 cases)and severe group(25 cases).According to prognosis,they were divided into good prognosis group(n=71)and poor prognosis group(n=23).A to⁃tal of 38 neonates with pneumonia during the same period were enrolled as pneumonia group.The changes of serum NT-proBNP and cTnT in different groups were compared.The evaluation value of serum NT-proBNP,cTnT and combined detection for poor prognosis was analyzed by receiver operating characteristic(ROC)curves.Results The levels of serum NT-proBNP and cTnT in HF group were(646.56±43.28)pg/mL and(0.43±0.08)ng/mL,higher than those in the pneumonia group(P<0.001).The levels of serum NT-proBNP and cTnT were the highest in the severe group,followed by the moderate group and mild group(P<0.05).The levels of serum NT-proBNP and cTnT in the poor prognosis group were(668.98±39.84)pg/mL and(0.55±0.15)ng/mL,higher than those in the good prognosis group(P<0.05).The area under the curve(AUC)values of serum NT-proBNP,cTnT and combined detection for predicting poor prognosis of HF were 0.819,0.829 and 0.930,respectively.AUC of combined detection was greater than that of single index(P<0.05).Conclusions The levels of serum NT-proBNP and cTnT are corre⁃lated with the severity of heart failure in pneumonia neonates,and their combined detection can improve predictive value for poor prognosis in neonates with pneumonia and heart failure.
作者
戴梅
雷育军
孙骥
章则陈
DAI Mei;LEI Yujun;SUN Ji;ZHANG Zechen(Department of Laboratory Medicine,Xiantao First People's Hospital Affiliated to Yangtze University,Xiantao 433000,China;Department of Medical Anesthesiology,Xiantao First People's Hospital Affiliated to Yangtze University,Xiantao 433000,China)
出处
《安徽医学》
2023年第4期405-409,共5页
Anhui Medical Journal
基金
仙桃市2021年指导性科技研究与开发计划项目(编号:XKW202104)。
关键词
肺炎
心力衰竭
N端脑钠肽前体
心肌肌钙蛋白T
心肌损伤
Pneumonia
Heart failure
N-terminal pro-brain natriuretic peptide
Cardiac troponin T
Myocardial damage
