ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (4): 301-303.doi: 10.3969/j.issn.1674-3865.2017.04.009

• 临床研究 • 上一篇    下一篇

血N末端脑利钠肽原和降钙素原在川崎病诊断中的价值

王祥，陈智，肖云彬，杨舟，向金星，王野峰   

  1. 410007 长沙，湖南省儿童医院心血管内科
  • 出版日期:2017-08-25 发布日期:2017-12-08
  • 通讯作者: 王祥，E-mail：6953769@qq.com
  • 作者简介:王祥（1981-），男，主治医师。研究方向：小儿心血管疾病的诊治

Value of serum NT-proBNP and procalcitonin in the diagnosis of Kawasaki disease

WANG Xiang, CHEN Zhi, XIAO Yunbin, YANG Zhou, XIANG Jinxing, WANG Yefeng   

  1. Hunan Children's Hospital, Changsha  410007, China
  • Online:2017-08-25 Published:2017-12-08

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摘要：
目的
通过检测川崎病患儿血清N末端脑利钠肽原（NT-proBNP）以及降钙素原水平，探讨其在川崎病患儿诊断及预测冠状动脉损害中的价值。
方法
2015年3月至2016年8月湖南省儿童医院心血管内科收治住院的川崎病患儿65例。根据入院后超声心动图诊断，分为冠状动脉损害组28例和无冠状动脉损害组37例。同期选取本科住院的伴有发热的呼吸道感染患儿55例，为呼吸道感染组。同期选取门诊体检健康儿童40例作为正常组。川崎病患儿明确诊断后均给予大剂量静脉注射免疫球蛋白2 g/kg冲击治疗。1周后检测各组NT-proBNP以及川崎病患儿治疗前后降钙素原水平。
结果
川崎病组NT-proBNP水平高于正常组和呼吸道感染组，差异有统计学意义（P<0.01）。无冠状动脉损害组和呼吸道感染组NT-proBNP水平比较差异无统计学意义（P>0.05），无冠状动脉损害组和呼吸道感染组NT-proBNP水平高于正常组，差异有统计学意义（P<0.05）。冠状动脉损害组高于无冠状动脉损害组、呼吸道感染组及正常组，差异有统计学意义（P<0.05）。静脉注射免疫球蛋白治疗后降钙素原水平显著低于治疗前，差异有统计学意义（P<0.01）。
结论
血NT-proBNP水平用于鉴别川崎病与一般感染性疾病具有一定临床价值，且作为预测川崎病冠脉损害的指标具有较好的敏感性。血降钙素原水平在川崎病中是明显增高，尤以急性期明显，而是否是发生冠脉损害的危险因素，仍需进一步扩大样本量以验证。

关键词: 川崎病, N末端脑利钠肽原, 降钙素原, 儿童

Abstract:
Objective
To study the value of serum NT-proBNP and procalcitonin in the diagnosis of Kawasaki disease in children and in the prediction of damage to coronary arteries by determining their levels.
Methods
A total of 65 children with Kawasaki disease were hospitalized in Hunan Children's Hospital from Mar. 2015 to Aug. 2016.They were divided into two groups according to their ultrasonic cardiograms: the group of coronary artery damage(group A,28 children) and the group of no-damage to coronary artery(group B,37 children). A total of 55 children with respiratory infection complicated with fever treated in our hospital during the same period were included as the respiratory infection group(group C). Another 40 healthy children were chosen as the control group. The children with confirmed diagnosis of Kawasaki disease received pulse therapy with venous injection of large dose of immunoglobulin(2 g/kg). After one week, the level of NT-proBNP in each group was detected and the level of procalcitonin in children with Kawasaki disease before and after treatment was also detected.
Results
The level of NT-proBNP in group A and B was higher than that in group C and the control group(P<0.01). There was no statistical difference on NT-proBNP level between group B and group C(P>0.05), while its level in group A was higher than that in group B, group C and the control group (P<0.05).After treatment with venous injection of immunoglobulin, procalcitonin level was significantly lower than before treatment, and there was statistical difference(P<0.01).
Conclusion
Serum NT-proBNP level has some value in distinguishing Kawasaki disease from some common infections, and it's a sensitive indicator in predicting the coronary damage in Kawasaki disease. Procalcitonin level is significantly increased in Kawasaki disease, especially at acute stage; however it needs to be proved by more samples whether it is a risk factor of coronary artery damage.

Key words: Kawasaki disease, NT-proBNP, Procalcitonin, Child