肺炎合并心衰患儿血清脂肪酸结合蛋白与脑利钠肽的水平改变

Serum levels of fatty acid-binding protein and brain natriuretic peptide in children with pneumonia complicated by acute congestive heart failure

摘要:

目的：通过观察肺炎并心衰患儿血清脂肪酸结合蛋白(fatty acid-binding protein,FABP) 水平变化,并与脑利钠肽（brain natriuretic peptide，BNP）进行对比分析,探讨其在肺炎合并心衰患儿中的临床价值。方法：选择肺炎并心衰患儿36例为研究对象， 28例健康儿童为对照组,采用酶联免疫吸附试验进行定量检测FABP，BNP。结果：心衰期血清FABP，BNP水平均显著高于恢复期及对照组( 均P<0.01)，恢复期FABP，BNP水平亦显著高于对照组(均P<0.01)；心衰期、恢复期血清FABP的阳性率显著高于BNP升高的阳性率（均P<0.05）。结论：FABP，BNP血清浓度均可作为肺炎合并心衰患儿早期心肌损害的生化标志物，而FABP具有更高的灵敏度。恢复期患儿也有较高的FABP，BNP血浆浓度，提示临床症状好转但心肌损害仍可持续较长时间。

Abstract:

OBJECTIVE: To assess the values of serum fatty acid-binding protein （FABP) and brain natriuretic peptide (BNP） in pneumonia complicated by acute congestive heart failure (CHF) in children.METHODS: Serum levels of FABP and BNP were determined using ELISA in 36 children with pneumonia complicated by CHF (pneumonia group) and 28 healthy children (control group).RESULTS: Serum levels of FABP and BNP in the pneumonia group at the acute stage were significantly higher than those in the control group and those at the recovery stage (P<0.01). Compared with the control group, serum levels of FABP and BNP in the pneumonia group at the recovery stage increased significantly (P<0.01). At the acute stage, 35 patients (97.2%) showed increased serum FABP level but 28 (77.8%) showed increased serum BNP level (P<0.05) in the pneumonia group. At the recovery stage, the incidence of abnormal serum FABP (72.2%) was significantly higher than that of BNP (44.4%) in the pneumonia group (P<0.05).CONCLUSIONS: Serum levels of FABP and BNP can be regarded as biochemical markers of myocardial damage in children with pneumonia complicated by CHF and serum FABP appears to be a more sensitive one. Serum FABP and BNP remained at higher levels through the recovery stage, suggesting that myocardial damage existed though the clinical symptoms were improved at the stage.