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目的通过检测川崎病(kawasaki disease,KD)患儿血浆N端脑钠肽前体(N-terminalpro-brain natriuretie peptide,NT-proBNP)水平,探讨NT-proBNP在川崎病早期诊断中的临床意义。方法将收集的58例KD患儿分为两组,其中典型KD组45例,不完全KD组13例,另选择18例年龄匹配的发热患儿为对照组。采用酶联免疫法分别测定KD患儿急性期、恢复期,以及对照组血浆NT-proBNP水平。结果 KD组(包括典型KD组和不完全KD组)急性期血浆NT-proBNP水平显著高于对照组(P均<0.01);典型KD组和不完全KD组急性期血浆NT-proBNP水平无统计学差异(P>0.05)。KD患儿恢复期血浆NT-proBNP水平较急性期显著下降(P<0.05)。冠脉损伤组急性期血浆NT-proBNP水平显著高于无冠脉损伤组(P<0.05)。结论 KD(包括不典型KD)患儿急性期血浆NT-proBNP水平显著升高,尤其当存在冠状动脉损伤时升高更明显。检测血浆NT-proBNP水平对KD的诊断,尤其是不典型KD的诊断有一定的参考价值,血浆NT-proBNP水平异常升高对预测冠脉损伤的发生有一定的意义。
Objective To investigate the clinical significance of NT-proBNP in the early diagnosis of Kawasaki disease by detecting the plasma N-terminal pro-brain natriuretie peptide (NT-proBNP) in children with Kawasaki disease (KD). Methods Fifty-eight children with KD were divided into two groups. Among them, 45 cases were typical KD group, 13 cases were incomplete KD group and 18 age-matched fever children were selected as control group. Enzyme-linked immunosorbent assay was used to determine the plasma levels of NT-proBNP in children with KD at acute and convalescent stages, respectively. Results The level of plasma NT-proBNP in acute KD group (including typical KD group and incomplete KD group) was significantly higher than that in control group (all P <0.01). There was no statistical significance of plasma NT-proBNP level in acute KD group and incomplete KD group Learning difference (P> 0.05). The level of plasma NT-proBNP in convalescent children with KD was significantly lower than that in acute phase (P <0.05). The level of plasma NT-proBNP in acute coronary artery injury group was significantly higher than that in non-coronary artery injury group (P <0.05). Conclusion The plasma levels of NT-proBNP in children with KD (including atypical KD) are significantly increased in acute phase, especially when coronary artery injury is present. Detection of plasma NT-proBNP levels of KD diagnosis, especially atypical KD diagnosis has some reference value, abnormal plasma NT-proBNP levels to predict the occurrence of coronary artery injury has a certain significance.