脑钠肽和氨基末端脑钠尿肽原在儿童心血管疾病诊治中的进展

王野峰; 黄希勇

PDF(927 KB)

中国当代儿科杂志 ›› 2012, Vol. 14 ›› Issue (06) : 470-474.

综述

脑钠肽和氨基末端脑钠尿肽原在儿童心血管疾病诊治中的进展

王野峰，黄希勇

作者信息 +

Research advance of brain natriuretic peptide and N-terminal brain natriuretic peptide in the diagnosis and treatment of pediatric cardiovascular diseases

WANG Ye-Feng, HUANG Xi-Yong

Author information +

文章历史 +

摘要

脑钠肽(BNP)和氨基末端脑钠尿肽原(NT-proBNP)是儿童心血管疾病中的重要指标，其水平与儿童的年龄及性别相关。目前的研究表明，BNP与NT-proBNP对于心力衰竭（心衰）具有较高的诊断价值，特异性和敏感性均较高，有助于心衰与单纯性肺源性因素所致急性呼吸困难的鉴别。另外，在肺动脉高压、心肌病和川崎病的患儿中，BNP与NT-proBNP均可以有助于判断病情和指导治疗。目前的局限在于研究样本量相对偏小，检测方法及正常值范围未完全统一。

Abstract

Brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide (NT-proBNP) are important biomarkers for pediatric cardiovascular diseases. Peptide levels are associated with age and gender. Current studies have shown that BNP and NT-proBNP are valuable in the diagnosis of heart failure, with a high specificity and sensitivity. They also contribute to differentiating heart failure from acute respiratory distress induced by simple pulmonary factors. In addition, BNP and NT-proBNP are useful in the evaluation of disease severity and treatment guidance in children with pulmonary hypertension, cardiomyopathy and Kawasaki disease. Current limitations include the relatively small sample size of the study, the detection method and a range of normal values that are not completely uniform.

导出引用

王野峰，黄希勇. 脑钠肽和氨基末端脑钠尿肽原在儿童心血管疾病诊治中的进展[J]. 中国当代儿科杂志. 2012, 14(06): 470-474

WANG Ye-Feng, HUANG Xi-Yong. Research advance of brain natriuretic peptide and N-terminal brain natriuretic peptide in the diagnosis and treatment of pediatric cardiovascular diseases[J]. Chinese Journal of Contemporary Pediatrics. 2012, 14(06): 470-474

中图分类号： R725.4

参考文献

［1］Tang WH, Francis GS, Morrow DA, Newby LK, Cannon CP, Jesse RL, et al. National Academy of Clinical Biochemistry Laboratory Medicine practice guidelines: Clinical utilization of cardiac biomarker testing in heart failure［J］. Circulation, 2007, 116(5): e99-e109.

［2］武育蓉，陈树宝，孙锟，黄美蓉，张玉奇，陈笋. 现有儿科心力衰竭诊断标准及脑利钠肽对先天性心脏病合并心力衰竭的诊断价值［J］. 中华儿科杂志，2006，44（10）：728-732.

［3］Xu-Cai YO, Wu Q. Molecular forms of natriuretic peptides in heart failure and their implications［J］. Heart, 2010, 96(6): 419-424.

［4］Kuwahara K, Nakao K. Regulation and significance of atrial and brain natriuretic peptides as cardiac hormones［J］. Endocr J, 2010, 57(7), 555-565.

［5］Daniels LB, Allison MA, Clopton P, Redwine L, Siecke N, Taylor K, et al. Use of natriuretic peptides in preparticipation screening of college athletes［J］. Int J Cardiol, 2008, 124(3): 411-414.

［6］Koch A, Singer H. Normal values of B type natriuretic peptide in infants, children, and adolescents［J］. Heart, 2003, 89(8): 875-878.

［7］Law YM, Hoyer AW, Reller MD, Silberbach M. Accuracy of plasma B-type natriuretic peptide to diagnose significant cardiovascular disease in children［J］. J Am Coll Cardiol, 2009, 54(15): 1467-1475.

［8］Sugimoto M, Manabe H, Nakau K, Furuya A, Okushima K, Fujiyasu H, et al. The role of N-terminal pro-B-type natriuretic peptide in the diagnosis of congestive heart failure in children［J］. Circ J, 2010, 74(5): 998-1005.

［9］张伟令，杜忠东.正常儿童和心力衰竭患儿血清氨基末端脑钠肽的研究［J］.实用儿科临床杂志，2006，21（13）：811-812.

［10］Price JF, Thomas AK, Grenier M, Eidem BW, O'Brian Smith E, Denfield SW, et al. B-type natriuretic peptide predicts adverse cardiovascular events in pediatric outpatients with chronic left ventricular systolic dysfunction［J］. Circulation, 2006, 114(10): 1063-1069.

［11］Mangat J, Carter C, Riley G, Foo Y, Burch M. The clinical utility of brain natriuretic peptide in paediatric left ventricular failure［J］. Eur J Heart Fail, 2009, 11(1): 48-52.

［12］Auerbach SR, Richmond ME, Lamour JM, Blume ED, Addonizio LJ, Shaddy RE, et al. BNP levels predict outcome in pediatric heart failure patients: post hoc analysis of the Pediatric Carvedilol Trial［J］. Circ Heart Fail, 2010, 3(5): 606-611.

［13］Ariceta G, Brooks ER, Langman CB. Assessing cardiovascular risk in children with chronic kidney disease. B-type natriuretic peptide: a potential new marker［J］. Pediatr Nephrol, 2005, 20(12):1701-1707.

［14］Ouali S, Bougmiza I, Abroug S, Ormezzine A, Ben Salem H, Neffeti, et al. Relationship of brain natriuretic peptide concentrations to left ventricular function and adverse outcomes in children with end-stage renal disease undergoing hemodialysis［J］. Pediatr Cardiol, 2011, 32(5): 568-577.

［15］Cohen S, Springer C, Avital A, Perles Z, Rein AJ, Argaman Z, et al. Amino-terminal pro-brain-type natriuretic peptide: heart or lung disease in pediatric respiratory distress?［J］. Pediatrics, 2005, 115(5): 1347-1350.

［16］Koulouri S, Acherman RJ, Wong PC, Chan LS, Lewis AB. Utility of B-type natriuretic peptide in differentiating congestive heart failure from lung disease in pediatric patients with respiratory distress［J］. Pediatr Cardiol, 2004, 25(4): 341-346.

［17］安金斗，张彦萍，周建华.充血性心力衰竭与重症肺炎患儿血清脑钠素浓度变化的研究［J］. 中国当代儿科杂志，2006，8 （3）：201-204.

［18］Bernus A, Wagner BD, Accurso F, Doran A, Kaess H, Ivy DD. Brain natriuretic peptide levels in managing pediatric patients with pulmonary arterial hypertension［J］. Chest, 2009, 135(3): 745-751.

［19］Lammers AE, Hislop AA, Haworth SG. Prognostic value of B-type natriuretic peptide in children with pulmonary hypertension［J］. Int J Cardiol, 2009, 135(1): 21-26.

［20］Reynolds EW, Ellington JG, Vranicar M,Bada HS. Brain-type natriuretic peptide in the diagnosis and management of persistent pulmonary hypertension of the newborn［J］. Pediatrics, 2004, 114(5): 1297-1304.

［21］Cowley CG, Bradley JD, Shaddy RE. B-type natriuretic peptide levels in congenital heart disease［J］. Pediatr Cardiol, 2004, 25(4): 336-340.

［22］Mir TS, Falkenberg J, Friedrich B, Gottschalk U, Le TP, Laer S, et al. Levels of brain natriuretic peptide in children with right ventricular overload due to congenital cardiac disease［J］. Cardiol Young, 2005, 15(4): 396-401.

［23］Paul MA, Backer CL, Binns HJ, Mavroudis C, Webb CL, Yogev R, et al. B-Type natriuretic peptide and heart failure in patients with ventricular septal defect: a pilot study［J］. Pediatr Cardiol, 2009, 30(8): 1094-1097.

［24］Pietrzak R, Werner B. Usefulness of NT-proBNP in assessment of right ventricular function in children after tetralogy of Fallotcorrection-a preliminary study［J］. Kardiol Pol, 2009, 67(4): 378-383.

［25］Shah A, Feraco AM, Harmon C, Tacy T, Fineman JR, Bernstein HS. Usefulness of various plasma biomarkers for diagnosis of heart failure in children with single ventricle physiology［J］. Am J Cardiol, 2009, 104(9): 1280-1284.

［26］Kaski JP, Tomé-Esteban MT, Mead-Regan S, Pantazis A, Marek J, Deanfield JE, et al. B-type natriuretic peptide predicts disease severity in children with hypertrophic cardiomyopathy［J］. Heart, 2008, 94(10): 1307-1311.

［27］Rusconi PG, Ludwig DA, Ratnasamy C, Mas R, Harmon WG, Colan SD, et al. Serial measurements of serum NT-proBNP as markers of left ventricular systolic function and remodeling in children with heart failure［J］. Am Heart J, 2010, 160(4): 776-783.

［28］李荣，易岂建，钱永如，刘晓燕，钟家蓉，白永虹，等.卡维地洛治疗原发性心内膜弹力纤维增生症的研究［J］.中华儿科杂志，2008，46（9）：684-687.

［29］Babuin L, Alegria RJ, Oh JK, Nishimura RA, Jaffe AS. Brain natriuretic peptide levels in constrictive pericarditis and restrictive cardiomyopathy［J］. J Am Coll Cardiol, 2006, 47(7): 1489-1491.

［30］Takeuchi D, Saji T, Takatsuki S, Fujiwara M. Abnormal tissue doppler images are associated with elevated plasma brain natriuretic peptide and increased oxidativestress in acute Kawaski disease［J］. Circ J, 2007, 71(3): 357-362.

［31］Dahdah N, Siles A, Fournier A, Cousineau J, Delvin E, Saint Cyr C, et al. Natriuretic peptide as an adjunctive diagnostic test in the acute phase of kawasaki disease［J］. Pediatr Cardiol, 2009, 30(6): 810-817.

［32］孙裕平，王文棣，郑兴厂，王金菊，马少春，徐迎军.川崎病患儿血浆脑利钠肽水平改变及其与心功能的关系［J］. 中国当代儿科杂志，2010，12（3）：169-171.

［33］Jefferies JL, Denfield SW, Price JF, Dreyer WJ, McMahon CJ, Grenier MA, et al. A prospective evaluation of nesiritide in the treatment of pediatric heart failure［J］. Pediatr Cardiol, 2006, 27 (4): 402-407.

［34］Mahle WT, Cuadrado AR, Kirshbom PM, Kanter KR, Simsic JM. Nesiritide in infants and children with congestive heart failure［J］. Pediatr Crit Care Med, 2005, 6 (5): 543-546.