Objective To investigate the diagnosis value and differential diagnosis value of serum N-ter-minal pro-brain natriuretic peptide ( NT-proBNP) on neonatal cardiac dyspnea and noncardiac dyspnea. Methods Total of 128 neonates with acute dyspnea from Baoji Central Hospital during Jan.2013 and Feb. 2014 were chosen,according to the cause of dyspnea,they were divided into cardiac dyspnea(cardiac group, n=56) and noncardiac dyspnea (noncardiac group,n =72),and another 40 healthy neonates during the same period were selected as control group.The cardiac dyspnea neonates were classified into classⅠ(31 cases),Ⅱ(18 cases) and Ⅲ(7 cases) according to ROSS classification and left ventricular ejection fraction ( LVEF) was measured by cardiac ultrasonography.The levels of serum NT-proBNP were detected by automated electrochemical luminescence and compared between the groups.Results The level of serum NT-proBNP in the cardiac group was (4922 ±1244) ng/L,in the noncardiac group was (314 ±47) ng/L,in the control group was (58 ±22) ng/L,the differences were statistically significant(P <0.05).With the upgrade of cardiac function classification increasing,the levels of serum NT-proBNP increased with significant difference(P<0.05).The levels of serum NT-proBNP had a negative correlation with LVEF(r=-0.564, P<0.05).Conlusion Detection of serum NT-proBNP has a great clinical significance to the diagnosis and differential diagnosis of cardiac dyspnea and noncardiac dyspnea in neonates.%目的：探讨血清N末端B型脑钠肽前体（ NT-proBNP）检测在新生儿心源性与非心源性呼吸困难诊断及鉴别诊断中的应用。方法选择2013年1月至2014年2月宝鸡市中心医院小儿科收治的以呼吸困难为主要症状的新生儿患者128例，根据病因不同分为心源性呼吸困难（心源性组）56例，非心源性呼吸困难（非心源性组）72例，同时选择健康新生儿40例作为对照组。依据改良ROSS新生儿心功能分级标准，将心源性组患儿分为心功能Ⅰ级31例、Ⅱ级18例、Ⅲ级7例，采用心脏超声检测患儿左心室射血分数（LVEF）。采用电化学发光法检测血清 NT-proBNP的水平并进行组间比较。结果心源性组血清NT-proBNP水平为（4922±1244） ng／L，非心源性组为（314±47） ng／L，对照组为（58±22） ng／L，心源性组和非心源性组高于对照组，心源性组高于非心源性组，差异均有统计学意义（P＜0.05）。随着患儿新功能分级的升高，血清 NT-proBNP水平逐渐增高，差异有统计学意义（P＜0.05），血清 NT-proBNP 水平与 LVEF 呈负相关（r ＝－0.564，P ＜0.05）。结论血清NT-proBNP水平检测在新生儿心源性与非心源性急性呼吸困难的诊断及鉴别诊断中具有重要的临床意义。
展开▼
