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目的探讨肺炎合并急性心力衰竭(AHF)患儿的和肽素(Copetin)、脑钠肽(BNP)表达水平及相关性。方法选取2015年7月-2016年7月该院收治的60例肺炎患儿为研究对象,按照是否合并AHF分为肺炎AHF组(30例)和肺炎无AHF组(30例)两组,同期选取30例健康体检儿童作为对照组,采用酶联免疫吸附法(ELISA)检测所有受试儿童外周血Copeptin、BNP水平,采用多普勒超声心动图测定仪测定患儿的左心室舒张末期内径和左心室收缩末期内径,计算左心室射血分数(LVEF)。结果肺炎AHF组Copeptin水平明显高于肺炎无AHF组,差异有统计学意义(F=71.465,P<0.05),肺炎无AHF组Copeptin水平与对照组比较差异无统计学意义(t=1.453,P>0.05);肺炎AHF组BNP水平明显高于肺炎无AHF组,差异有统计学意义(F=484.39,P<0.05),肺炎无AHF组BNP水平明显高于对照组,差异有统计学意义(t=30.181,P<0.05);肺炎AHF组LVEF明显低于肺炎无AHF组,差异有统计学意义(F=214.761,P<0.05),肺炎无AHF组LVEF与对照组比较差异无统计学意义(t=1.782,P>0.05);Logistic回归分析结果显示:Copeptin、BNP、LVEF是小儿肺炎合并AHF的独立危险因素(P<0.05);相关性分析结果显示,Copeptin、BNP与LVEF均呈现明显负性相关(r=-0.573,-0.784,P<0.05)。结论Copeptin、BNP与小儿肺炎合并AHF发生密切相关,推测二者有望成为儿童肺炎早期识别心力衰竭(HF)的血清学诊断指标及治疗新靶点。
Objective To investigate the expression of copetin and brain natriuretic peptide (BNP) in children with pneumonia complicated with acute heart failure (AHF). Methods Sixty children with pneumonia admitted from July 2015 to July 2016 in our hospital were enrolled in this study. The patients were divided into AHF group (30 cases) and AHF group (30 cases) Thirty healthy children were selected as the control group. The levels of Copeptin and BNP in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). The left ventricular end-diastolic diameter and left ventricular diameter were measured by Doppler echocardiography. Left ventricular end-systolic diameter, left ventricular ejection fraction (LVEF) was calculated. Results The level of Copeptin in AHF group was significantly higher than that in non-AHF group (F = 71.465, P <0.05). There was no significant difference in the level of Copeptin between AHF group and control group (t = 1.453, P > 0.05). The BNP level in AHF group was significantly higher than that in AHF group (P = 0.05). The BNP level in AHF group was significantly higher than that in control group (P <0.05) t = 30.181, P <0.05). The LVEF in AHF group was significantly lower than that in non-AHF pneumonia group (F = 214.761, P <0.05). There was no significant difference in LVEF between AHF group and control group (t = 1.782, P> 0.05). Logistic regression analysis showed that Copeptin, BNP and LVEF were independent risk factors for pneumonia complicated with AHF in children (P <0.05). Correlation analysis showed that Copeptin, BNP and LVEF were significantly Negative correlation (r = -0.573, -0.784, P <0.05). Conclusions Copeptin and BNP are closely related to pneumonia in children with AHF. It is speculated that both of them may be used as serological markers and new therapeutic targets for the early diagnosis of heart failure (HF) in children with pneumonia.