早期NT-proBNP升高但肌钙蛋白I升高与婴儿严重毛细支气管炎有关,Clinica Chimica Acta

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早期NT-proBNP升高但肌钙蛋白I升高与婴儿严重毛细支气管炎有关
Clinica Chimica Acta ( IF 3.2 ) Pub Date : 2021-04-06 , DOI: 10.1016/j.cca.2021.03.023
Moisés Rodríguez-González ₁ , Lorena Estepa-Pedregosa ₂ , Ana Estalella-Mendoza ₂ , Ana Castellano-Martínez ₃ , Patricia Rodríguez-Campoy ₂ , Jose Carlos Flores-González ₂

Affiliation

背景

我们旨在探讨和比较急性细支气管炎早期与超声心动图改变，临床严重程度和预后之间NT-proBNP和高敏感性肌钙蛋白I（hs-cTnI）之间的关系。

方法

一项单中心，前瞻性观察性研究，包括从2019年4月至2020年3月在三级医院就诊的1-12个月以前毛细支气管炎的健康婴儿。所有患者均在入院后12小时内同时接受了临床，实验室和超声心动图评估。NT-proBNP> 1121 pg / ml和hs-cTnI> 26 ng / L被认为升高。主要结果指标是心脏生物标志物升高与PICU入院的相关性。

结果

我们招募了40例入院时NT-proBNP中位水平为1176（520-3030）pg / ml和hs-cTnI为11.5（5-21）ng / L的婴儿。NT-proBNP和hs-cTnI的水平分别升高了50％和20％。其中有15名（37％）住院期间需要PICU入院。NT-proBNP升高与入院（调整后的OR 9.5（CI95％1.4-64）; p = 0.020），住院时间延长（β= 2.7; p = 0.012）和持续吸氧时间（β= 2.7; p = 0.004）相关。）进行多元分析。关于PICU入院，hs-cTnI水平无差异（p = 0.866）。升高的hs-cTnI水平仅与给药时间有关（Spearman rho = 0.38; p = 0.017），但这种关联在多变量分析中消失了。

结论

早期NT-proBNP升高而不是hs-cTnI升高可作为细支气管炎中心肌劳损和疾病严重程度的生物标志物

"点击查看英文标题和摘要"

Early elevated NT-proBNP but not Troponin I is associated with severe bronchiolitis in infants

Background

We aimed to explore and to compare the association between the NT-proBNP and high-sensitivity troponin I (hs-cTnI) at early stages of acute bronchiolitis with echocardiographic alterations, clinical severity and outcomes.

Methods

A single centre, prospective observational study including previously healthy infants aged 1-12 months with bronchiolitis admitted to a tertiary hospital from April 2019 to March 2020. All patients underwent clinical, laboratory and echocardiographic evaluation at the same time point within 12 hours of hospital admission. NT-proBNP > 1121 pg/ml and hs-cTnI > 26 ng/L were considered elevated. The primary outcome measure was the association of raised cardiac biomarkers with the need for PICU admission.

Results

We enrolled 40 infants with median levels of NT-proBNP of 1176 (520-3030) pg/ml and hs-cTnI of 11.5 (5-21) ng/L at the time of hospital admission. Raised levels of NT-proBNP and hs-cTnI in 50% and 20% of cases, respectively. Of them, 15 (37%) required PICU admission during the hospitalization. Increased NT-proBNP was associated with PICU admission (adjusted OR 9.5 (CI95% 1.4-64); p=0.020), prolonged hospitalization (β=2.7; p=0.012) and duration of oxygen administration (β=2.7; p=0.004) in the multivariate analysis. There were no differences in hs-cTnI levels regarding PICU admission (p=0.866). Increased hs-cTnI levels were only associated with oxygen administration duration (Spearman rho=0.38; p=0.017), but this association disappeared in the multivariate analysis. Only NT-proBNP was associated with echocardiographic parameters of myocardial dysfunction (p<0.001), and pulmonary hypertension (p<0.001)