目的探讨血浆脑钠肽(BNP)水平与新生儿窒息后心肌损伤之间的关系。方法选取武汉大学中南医院新生儿科2012年12月至2013年12月收治的窒息患儿,按就诊顺序编号,每间隔1例纳入观察组1例,按照是否有心肌损伤分为心肌损伤组和非心肌损伤组,同时选取同期收治的无窒息史及心血管系统疾病的新生儿为对照组,除外水电解质紊乱和肝肾功能障碍,两组患儿均要求入院日龄<3天。对所有入选患儿在入院2 h内及入院第14天测定血浆BNP、肌酸激酶同工酶(CK-MB)、血钙及血钠等并进行统计分析。结果收集了107例窒息儿,其中77例有完整资料,入选为窒息观察组,其中心肌损伤组36例,非心肌损伤组41例,对照组共入选29例。经log转换后,入院2 h内心肌损伤组血浆BNP水平明显高于非心肌损伤组及对照组[(2.35±0.44)比(2.12±0.64)、(1.88±0.27)],非心肌损伤组高于对照组,差异有统计学意义(P<0.05)。窒息患儿血浆BNP与CK-MB成正相关(r=0.212,P=0.030)。心肌损伤患儿经过治疗,入院第14天时血浆BNP水平较入院2 h内明显下降,差异有统计学意义(P<0.05)。心肌损伤患儿BNP的cutoff值为108.05 pg/ml时,ROC曲线下面积为0.753,敏感度75.0%,特异度64.5%,阳性预测值56.4%,阴性预测值72.3%。结论血浆BNP水平能反映窒息患儿心肌损伤情况,对指导治疗具有重要的临床意义。 Objective To investigate the relationship between plasma brain natriuretic peptide (BNP) and myocardial injury after neonatal asphyxia. Methods Zhongnan Hospital of Wuhan University neonatal department admitted from December 2012 to December 2013 asphyxiated children, according to the order of treatment numbers, one case at intervals were included in the observation group of 1 case, according to whether there is a myocardial injury divided into myocardial injury group and non- At the same time, newborns without asphyxia and cardiovascular diseases were selected as the control group except for the electrolyte imbalance and liver and kidney dysfunction. Both groups were required to have admission days <3 days. Plasma BNP, creatine kinase (CK-MB), serum calcium and serum sodium were measured within 2 h after admission and on the 14th day of admission for statistical analysis. Results A total of 107 asphyxiated children were collected. Among them, 77 had complete information and were included in the asphyxial observation group, with 36 cases of myocardial injury and 41 cases of non-myocardial injury. The control group was enrolled in 29 cases. After log conversion, the level of plasma BNP in myocardial injury group within 2 h after admission was significantly higher than that in non-myocardial injury group and control group [(2.35 ± 0.44) vs. (2.12 ± 0.64), (1.88 ± 0.27)], In the control group, the difference was statistically significant (P <0.05). Asphyxia children plasma BNP and CK-MB were positively correlated (r = 0.212, P = 0.030). After treatment of children with myocardial injury, plasma BNP levels decreased significantly on the 14th day after hospital admission, with significant difference (P <0.05). The cutoff value of BNP in children with myocardial injury was 108.05 pg / ml, the area under the ROC curve was 0.753, the sensitivity was 75.0%, the specificity was 64.5%, the positive predictive value was 56.4% and the negative predictive value was 72.3%. Conclusion The plasma BNP level can reflect the myocardial injury in children with asphyxia, which is of important clinical significance for guiding the treatment.