| 摘要: |
| 目的：探讨能在早期有效评估儿童社区获得性肺炎（CAP）病情危重程度的指标，以指导临床医师决策，减少并发症，降低病死率。方法：选取2013年9月至2016年12月在昆明市儿童医院急诊科治疗的CAP患儿600例，根据病情临床转归分为转归良好组328例和转归不良组272例，比较两组患儿性别、年龄、发病时间、体质量、外周血白细胞计数、C-反应蛋白、血清B型钠尿肽（BNP）、儿童早期预警评分（PEWS）及小儿危重症病例评分（PCIS）的差异，评价血清BNP水平对儿童CAP临床转归的评估能力。结果：转归不良组患儿入院时血清BNP水平为（193.8±32.7）pg/mL，高于转归良好组的（46.8±9.6）pg/mL（P<0.01）。血清BPN水平与PEWS和PCIS均呈正相关性，且对儿童CAP临床转归具有更高的评估价值（AUC=0.972，P<0.05）。结论：血清BNP水平可作为早期评估儿童CAP病情严重程度和临床转归的可靠指标。 |
| 关键词: B型钠尿肽 儿童 社区获得性肺炎 |
| DOI：doi:10.13407/ j.cnki.jpp.1672-108X.2019.10.005 |
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| 基金项目:2018 年度昆明市卫生和计划生育委员会医药卫生科技计划项目,编号2018-06-01-002。 |
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| Clinical Value of B-Type Natriuretic Peptide in the Evaluation of Community Acquired Pneumonia in Children |
| 李静，彭翠英，罗芳梅，张海霞，杨智，王婷，曹静 |
| (湖南省儿童医院，长沙 410000) |
| Abstract: |
| Objective: To explore the indicators that can effectively evaluate the critical severity of community-acquired pneumonia (CAP) in children at an early stage, so as to guide clinicians to provide diagnosis and treatment, and reduce the complications and mortality. Methods: A total of 600 children with CAP admitted into emergency department of Kunming Children’s Hospital from Sept. 2013 to Dec. 2016 were extracted. According to the clinical prognosis, all children were divided into 328 cases in the group with good prognosis and 272 cases in the group with poor prognosis. Differences of gender, age, onset time, body mass, peripheral blood white blood cell count, C-reactive protein, serum B-type natriuretic peptide (BNP), pediatric early warning score (PEWS) and pediatric critical illness case score (PCIS) of two groups were compared. Evaluation of serum BNP levels in the assessment of clinical outcomes in children with CAP was conducted. Results: The serum BNP level was (193.8±32.7) pg/mL on admission in the group with poor prognosis, higher than (46.8±9.6) pg/mL in the group with good prognosis (P<0.01). Serum BPN levels were positively correlated with PEWS and PCIS, which had higher evaluation value for clinical prognosis of children with CAP (AUC=0.972, P<0.05). Conclusion: Serum BNP levels can be used as a reliable indicator for early assessment of the severity and clinical prognosis of children with CAP. |
| Key words: B-type natriuretic peptide children community acquired pneumumonia |
