Clinical value of N-terminal pro-brain natriuretic peptide in the diagnosis of myocardial injury after asphyxia of newborns
10.3969/j.issn.1671-8348.2016.16.020
- VernacularTitle:N 端脑利钠肽前体对新生儿窒息合并心肌损伤诊断的临床价值
- Author:
Min HU
;
Jian WU
;
Zhirui ZHANG
;
Yanli LI
;
Guoqing FAN
;
Juan LUO
;
Jie XU
- Publication Type:Journal Article
- Keywords:
asphyxia;
infant,newborn;
myocardial injury;
Nt-proBNP
- From:
Chongqing Medicine
2016;45(16):2223-2225,2228
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changes and clinical significance of plasma N‐terminal pro‐brain natriuretic peptide (Nt‐proBNP) in patients with asphyxia of newborns combined with myocardial injury .Methods Fifty‐eight term neonates with neonatal asphyxia born within 24 h were included in our study ,18 of the 25 severe asphyxia cases were combined with myocardial injury ,15 of 33 mild asphyxia cases were with myocardial injury ,there were 25 subjects were not cardiac injured after asphyxia to‐tally .Patients of the same age without asphyxia or any cardiovascular disease were recruited into the control group .Levels of plasma Nt‐proBNP and creatine kinase isoenzyme (CK‐MB) were detected on the first ,third and the fifth days after birth for statistical a‐nalysis .Results On the first and third days after birth ,levels of plasma Nt‐proBNP in severe and mild asphyxia combined with my‐ocardial injury group were significantly higher than the groups without myocardial injury and the control (P<0 .05) .Levels of plas‐ma Nt‐proBNP in severe asphyxia myocardial injured group were significantly higher than those of the mild asphyxia myocardial in‐jured ones (P<0 .05) .On the fifth day ,the levels of plasma Nt‐proBNP in severe asphyxia myocardial injured group were signifi‐cantly higher than others (P<0 .05) .There was no difference in Nt‐proBNP levels between mild asphyxia myocardial injured group and the ones without myocardial injury (P>0 .05) .On the first day after birth ,levels of Nt‐proBNP ,CK‐MB were positively corre‐lated in the mild asphyxia group (r=0 .58 ,P<0 .05) and severe asphyxia group (r=0 .47 ,P<0 .05) .On the first day after birth , the cutoff value for myocardial injury was 695 .87 fmol/mL ,the area under the ROC curve was 0 .763 ,with the sensitivity of 71 .9%and specificity of 65 .4% ,the positive predictive value was 73 .3% and negative predictive value was 63 .8% .Conclusion The Nt‐proBNP level has important clinical value for early evaluation of the severity of myocardial injury after asphyxia .
