儿童心力衰竭诊断的研究进展

doi:10.7499/j.issn.1008-8830.2410105

摘要
图/表
参考文献(48)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (592 KB) [HTML]
输出: BibTeX | EndNote (RIS) 背景资料

摘要心力衰竭是一组复杂的临床综合征。儿童心力衰竭（pediatric heart failure, PHF）具有较高的病死率。早期诊断对于PHF的治疗和管理至关重要。在临床实践中，各种检验和检查在PHF的诊断中扮演着关键角色，包括不断更新的生物标志物、超声心动图、心脏磁共振等。该文重点梳理PHF诊断的生物标志物、检查、联合检测及临床模型、分级及分期的相关研究，期望为PHF的诊断提供思路和方向。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	雷诗意
	李晨阳
	刘玲娟
	袁宇星
	田杰

关键词 ：心力衰竭, 诊断, 生物标志物, 联合检测, 临床模型, 分级与分期, 儿童

Abstract：Heart failure is a complex clinical syndrome and pediatric heart failure (PHF) has a high mortality rate. Early diagnosis is crucial for treatment and management of PHF. In clinical practice, various tests and examinations play a key role in the diagnosis of PHF, including continuously updated biomarkers, echocardiography, and cardiac magnetic resonance imaging. This article focuses on summarizing relevant research on biomarkers, examinations, combined testing, clinical models, and the grading and staging of PHF diagnosis, aiming to provide insights and directions for the diagnosis of PHF.

Key words： Heart failure Diagnosis Biomarker Combined testing Clinical model Grading and staging Child

收稿日期: 2024-10-25

通讯作者: 田杰，男，主任医师，教授，Email：jietian@cqmu.edu.cn； E-mail: jietian@cqmu.edu.cn

作者简介: 雷诗意，女，硕士研究生，住院医师；

引用本文:

雷诗意,李晨阳,刘玲娟等. 儿童心力衰竭诊断的研究进展[J]. 中国当代儿科杂志, 2025, 27(1): 127-132.

LEI Shi-Yi,LI Chen-Yang,LIU Ling-Juan et al. Research progress on the diagnosis of pediatric heart failure[J]. CJCP, 2025, 27(1): 127-132.

链接本文:

http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2410105 或 http://www.zgddek.com/CN/Y2025/V27/I1/127

	Kantor PF, Lougheed J, Dancea A, et al. Presentation, diagnosis, and medical management of heart failure in children: Canadian Cardiovascular Society guidelines[J]. Can J Cardiol, 2013, 29(12): 1535-1552. PMID: 24267800. DOI: 10.1016/j.cjca.2013.08.008.
	中华医学会儿科学分会心血管学组, 中国医师协会心血管内科医师分会儿童心血管专业委员会, 中华儿科杂志编辑委员会. 儿童心力衰竭诊断和治疗建议（2020年修订版）[J]. 中华儿科杂志, 2021, 59(2): 84-94. PMID: 33548953. DOI: 10.3760/cma.j.cn112140-20200619-00737.
	Shaddy RE, George AT, Jaecklin T, et al. Systematic literature review on the incidence and prevalence of heart failure in children and adolescents[J]. Pediatr Cardiol, 2018, 39(3): 415-436. PMID: 29260263. PMCID: PMC5829104. DOI: 10.1007/s00246-017-1787-2.
	Amdani S, Marino BS, Rossano J, et al. Burden of pediatric heart failure in the United States[J]. J Am Coll Cardiol, 2022, 79(19): 1917-1928. PMID: 35550689. DOI: 10.1016/j.jacc.2022.03.336.
	Salem SS, Saleh NY, Soliman SE, et al. On-admission plasma levels of BNP, MR-proADM, and cTnI in pediatric heart failure: contributions to diagnosis, prognosis, and outcome[J]. Ir J Med Sci, 2022, 191(1): 263-270. PMID: 33564973. DOI: 10.1007/s11845-021-02533-2.
	6 郭洲萍, 谢佩倍, 张杨, 等. NT-proBNP检测在赣南基层医院儿童心力衰竭早期识别的应用[J]. 当代医学, 2019, 25(20): 122-123. DOI: 10.3969/j.issn.1009-4393.2019.20.049.
	7 谢雨桐. N末端脑钠肽前体在儿童高原性心脏病合并心力衰竭病情评估中的价值分析[J]. 高原医学杂志, 2023, 33(2): 7-11. DOI: 10.3969/j.issn.1007-3809.2023.02.002.
	McGinn C, Casey FA, Watson C, et al. Paediatric heart failure - understanding the pathophysiology and the current role of cardiac biomarkers in clinical practice[J]. Cardiol Young, 2023, 33(4): 503-513. PMID: 36951045. DOI: 10.1017/S1047951123000331.
	Tawiah KD, Franks CE, Tang J, et al. Comparison between BNP and NT-proBNP in pediatric populations[J]. Clin Biochem, 2022, 109-110: 74-78. PMID: 35940296. DOI: 10.1016/j.clinbiochem.2022.08.003.
	El-Amrousy D, Hassan S, Hodeib H. Prognostic value of homocysteine and highly sensitive cardiac troponin T in children with acute heart failure[J]. J Saudi Heart Assoc, 2018, 30(3): 198-204. PMID: 29983495. PMCID: PMC6026391. DOI: 10.1016/j.jsha.2017.11.007.
	Hamza A, Omokhodion SI. Accuracy of whole blood cardiac troponin i in the diagnosis of childhood heart failure at the University College Hospital, Ibadan[J]. West Afr J Med, 2023, 40(3): 254-261. PMID: 37017302.
	12 孟斌, 王炜, 杨晨. 氨基末端脑钠肽前体和心肌肌钙蛋白T联合检测诊断小儿肺炎合并心力衰竭的应用价值[J]. 中国实用医药, 2021, 16(29): 89-91. DOI: 10.14163/j.cnki.11-5547/r.2021.29.033.
	13 张欣, 马丽娟. 儿童心脏标志物检测的临床意义[J]. 检验医学, 2023, 38(6): 505-509. DOI: 10.3969/j.issn.1673-8640.2023.06.001.
	Lam E, Higgins V, Zhang L, et al. Normative values of high-sensitivity cardiac troponin T and N-terminal pro-B-type natriuretic peptide in children and adolescents: a study from the CALIPER cohort[J]. J Appl Lab Med, 2021, 6(2): 344-353. PMID: 32995884. DOI: 10.1093/jalm/jfaa090.
	Ameh A, Brady JJ. Reference intervals for high sensitivity cardiac troponin I and N-terminal pro-B-type natriuretic peptide in children and adolescents on the Siemens Atellica[J]. Clin Chem Lab Med, 2024, 62(8): 1636-1642. PMID: 38373095. DOI: 10.1515/cclm-2023-0977.
	16 马岩岩, 冯嵩, 李冰露, 等. 慢性心力衰竭患儿血清心型脂肪酸结合蛋白、可溶性ST2蛋白变化及意义[J]. 临床儿科杂志, 2015(9): 802-806. DOI: 10.3969/j.issn.1000-3606.2015.09.010.
	Saleh N, Khattab A, Rizk M, et al. Value of galectin-3 assay in children with heart failure secondary to congenital heart diseases: a prospective study[J]. BMC Pediatr, 2020, 20(1): 537. PMID: 33248453. PMCID: PMC7697383. DOI: 10.1186/s12887-020-02427-9.
	F?g?r??an A, S?s?ran M, Gozar L, et al. The role of galectin-3 in predicting congenital heart disease outcome: a review of the literature[J]. Int J Mol Sci, 2023, 24(13): 10511. PMID: 37445687. PMCID: PMC10342020. DOI: 10.3390/ijms241310511.
	Kaier TE, Twerenbold R, Puelacher C, et al. Direct comparison of cardiac myosin-binding protein C with cardiac troponins for the early diagnosis of acute myocardial infarction[J]. Circulation, 2017, 136(16): 1495-1508. PMID: 28972002. PMCID: PMC5642333. DOI: 10.1161/CIRCULATIONAHA.117.028084.
	El Amrousy D, Hodeib H, Suliman G, et al. Diagnostic and prognostic value of plasma levels of cardiac myosin binding protein-C as a novel biomarker in heart failure[J]. Pediatr Cardiol, 2017, 38(2): 418-424. PMID: 27878630. DOI: 10.1007/s00246-016-1532-2.
	Ratnasamy C, Kinnamon DD, Lipshultz SE, et al. Associations between neurohormonal and inflammatory activation and heart failure in children[J]. Am Heart J, 2008, 155(3): 527-533. PMID: 18294492. DOI: 10.1016/j.ahj.2007.11.001.
	Li G, Song X, Xia J, et al. The diagnostic value of plasma N-terminal connective tissue growth factor levels in children with heart failure[J]. Cardiol Young, 2017, 27(1): 101-108. PMID: 26979242. DOI: 10.1017/S1047951116000196.
	Chi H, Feng H, Shang X, et al. Circulating connective tissue growth factor is associated with diastolic dysfunction in patients with diastolic heart failure[J]. Cardiology, 2019, 143(3/4): 77-84. PMID: 31466059. DOI: 10.1159/000499179.
	Dervisoglu P, Elmas B. Pentraxin 3 as a marker for cardiovascular disease risk in overweight and obese children[J]. Acta Cardiol Sin, 2021, 37(2): 177-183. PMID: 33716459. PMCID: PMC7953122. DOI: 10.6515/ACS.202103_37(2).20201006A.
	25 张凤华. 血清正五聚体蛋白-3、多配体蛋白聚糖-4在儿童慢性心力衰竭中的变化及临床意义[D]. 郑州: 郑州大学, 2021.
	26 刘菲, 赵洋洋, 武鑫, 等. 联合检测脂联素和NT-proBNP在小儿肺炎合并心力衰竭中的诊断价值[J]. 中西医结合心脑血管病杂志, 2020, 18(6): 936-938. DOI: 10.12102/j.issn.1672-1349.2020.06.017.
	El Amrousy D, Abdelhai D, Nassar M. Predictive value of plasma copeptin level in children with acute heart failure[J]. Pediatr Cardiol, 2022, 43(8): 1737-1742. PMID: 35532808. PMCID: PMC9587970. DOI: 10.1007/s00246-022-02909-w.
	de Waal K, Costley N, Phad N, et al. Left ventricular diastolic dysfunction and diastolic heart failure in preterm infants[J]. Pediatr Cardiol, 2019, 40(8): 1709-1715. PMID: 31598743. DOI: 10.1007/s00246-019-02208-x.
	Xiang X, Zhu X, Zheng M, et al. Comparison of two echocardiography-based methods for evaluating pediatric left ventricular diastolic dysfunction[J]. Front Pediatr, 2023, 11: 1206314. PMID: 37732011. PMCID: PMC10507386. DOI: 10.3389/fped.2023.1206314.
	Van der Ende J, Vázquez Antona CA, Erdmenger Orellana J, et al. Left ventricular longitudinal strain measured by speckle tracking as a predictor of the decrease in left ventricular deformation in children with congenital stenosis of the aorta or coarctation of the aorta[J]. Ultrasound Med Biol, 2013, 39(7): 1207-1214. PMID: 23643058. DOI: 10.1016/j.ultrasmedbio.2013.02.015.
	31 Grosu V. The role of hemodynamic parameters in chronic heart failure diagnosis in children[J]. Ro J Med Pract, 2016, 11(2): 187-193. DOI: 10.37897/RJMP.2016.2.14.
	32 万青, 刘铭雅. 心脏核磁共振在心力衰竭中的应用价值[J]. 国际心血管病杂志, 2015, 42(2): 87-90. DOI: 10.3969/j.issn.1673-6583.2015.02.008.
	Banka P, Geva T. Advances in pediatric cardiac MRI[J]. Curr Opin Pediatr, 2016, 28(5): 575-583. PMID: 27428483. DOI: 10.1097/MOP.0000000000000400.
	34 刘仰生, 荣阳. X线诊断心力衰竭的价值与影像学研究[J]. 中国医药指南, 2020, 18(9): 126-127. DOI: 10.15912/j.cnki.gocm.2020.09.097.
	Mah K, Chen S, Chandhoke G, et al. QTc and QRS abnormalities are associated with outcome in pediatric heart failure[J]. Pediatr Cardiol, 2022, 43(8): 1903-1912. PMID: 35585243. DOI: 10.1007/s00246-022-02932-x.
	Cygankiewicz I, Zareba W, de Luna AB. Prognostic value of Holter monitoring in congestive heart failure[J]. Cardiol J, 2008, 15(4): 313-323. PMID: 18698539.
	37 侯小霞, 张延刚. 超声指数联合NT-proBNP、GDF-15对儿童心力衰竭诊治及预测价值[J]. 贵州医药, 2022, 46(6): 960-961. DOI: 10.3969/j.issn.1000-744X.2022.06.067.
	38 王栋, 秦艳妮, 景芳丽. cTnT、cTnⅠ、BNP及LVEF联合检测对先天性心脏病并发肺炎心力衰竭患儿的诊疗价值[J]. 海南医学, 2019, 30(15): 1972-1974. DOI: 10.3969/j.issn.1003-6350.2019.15.021.
	39 高悦, 庄海明, 张冰, 等. 儿童心力衰竭无创影像学多模态评价方法的研究[J]. 临床心血管病杂志, 2023, 39(12): 908-912. DOI: 10.13201/j.issn.1001-1439.2023.12.002.
	40 张砚茹. 婴儿急性心力衰竭早期预警评分的建立与检测[D]. 青岛: 青岛大学, 2022.
	41 谢国强, 任广立, 张庆梅, 等. 小儿重症肺炎并发心力衰竭的预测[J]. 临床急诊杂志, 2019, 20(10): 795-799. DOI: 10.13201/j.issn.1009-5918.2019.10.010.
	Luke RD, Omokhodion SI, Ogunkunle OO, et al. Diagnostic accuracy of a clinical scoring scheme in childhood heart failure[J]. West Afr J Med, 2021, 38(1): 67-74. PMID: 33463710.
	Patel MS, Berg AM, Vincent RN, et al. Serum parameters and echocardiographic predictors of death or need for transplant in newborns, children, and young adults with heart failure[J]. Am J Cardiol, 2010, 105(12): 1798-1801. PMID: 20538133. DOI: 10.1016/j.amjcard.2010.01.357.
	van Dalen EC, Leerink JM, Kremer LCM, et al. Risk prediction models for myocardial dysfunction and heart failure in patients with current or prior cancer[J]. Curr Oncol Rep, 2023, 25(4): 353-367. PMID: 36787043. DOI: 10.1007/s11912-023-01368-7.
	Almond CS, Chen S, Dykes JC, et al. The Stanford acute heart failure symptom score for patients hospitalized with heart failure[J]. J Heart Lung Transplant, 2020, 39(11): 1250-1259. PMID: 33032871. DOI: 10.1016/j.healun.2020.08.002.
	Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary a report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to revise the 1995 guidelines for the evaluation and management of heart failure): developed in collaboration with the International Society for Heart and lung transplantation; endorsed by the Heart Failure Society of America[J]. Circulation, 2001, 104(24): 2996-3007. PMID: 11739319. DOI: 10.1161/hc4901.102568.
	Amdani S, Conway J, George K, et al. Evaluation and management of chronic heart failure in children and adolescents with congenital heart disease: a scientific statement from the American Heart Association[J]. Circulation, 2024, 150(2): e33-e50. PMID: 38808502. DOI: 10.1161/CIR.0000000000001245.
	48 中华医学会儿科学分会心血管学组心力衰竭协作组, 中华医学会儿科学分会心血管学组儿童心肌病精准诊治协作组, 中国医师协会心血管医师分会儿童心血管专业委员会, 等. 中国儿童心力衰竭分期及管理建议[J]. 中国实用儿科杂志, 2024, 39(9): 659-664. DOI: 10.19538/j.ek2024090603.