Objective To evaluate the application value of serum heart type fatty acid binding protein ( H-FABP ), N-terminal pro-brain natriuretic peptide ( NT-proBNP ) and cardiac troponin I ( cTnl) in children with congenital heart diseases ( CHD ) and pneumonia and heart failure. Methods Serum H-FABP, NT-proBNP, and cTnl were detected in 27 children with CHD and pneumonia and heart failure (A group ), 23 children with CHD and pneumonia ( B group ), and 30 children with pneumonia only ( C group ). Results The positive rate of serum H-FABP, NT-proBNP, and cTnl were significantly difference between A, B, C groups. All of three index were higher in A group than those in B group (P < 0.05 ). Chi-square trend test shown that the positive rate of serum cTnl increased along with the deterioration of heart function. NT-proBNP and H-FABP did not show trends. Conclusions The positive rate of cTnl increased with the deterioration of heart function. The NT-proBNP and H-FABP showed a high positive rate in the early stage of heart failure, which can be as an early diagnosis serum marker of myocardial ischemic injury.%目的 比较血清心肌型脂肪酸结合蛋白(H-FABP)、末端脑钠肽原(NT-proBNP)及心肌肌钙蛋白I(cTnI)水平在患有肺炎的先天性心脏病(先心病)患儿中诊断心力衰竭时的应用价值.方法 对患有肺炎的先心病患儿合并心力衰竭(A组)27例、患有肺炎的先心病患儿无心力衰竭(B组)23例、无先心病且心功能正常的肺炎患儿(C组)30例进行血清H-FABP、NT-proBNP、cTnI检测,观察和比较不同心功能状态下这些指标的变化.结果 A、B、C组cTnI、NT-ProBNP、H-FABP阳性率比较,差异均有统计学意义(P均＜ 0.01);A组3项指标的阳性率均高于B组(P均＜ 0.05).A组心功能分级显示,随着心功能的恶化,cTnI的阳性率有增高趋势(P ＜ 0.05),而NT-ProBNP、H-FABP未显示出变化趋势(P ＞ 0.05).结论 随着心功能的恶化,cTnI阳性率增加,而NT-ProBNP、H-FABP在心力衰竭早期即表现出很高的阳性率,可作为诊断早期心肌缺血损伤的血清标志物.
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