围产期利钠肽在预测新生儿心力衰竭中的作用。

Utility of perinatal natriuretic peptide for predicting neonatal heart failure.

机构信息

Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Suita, Japan.

Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan.

出版信息

Pediatr Int. 2022 Jan;64(1):e15231. doi: 10.1111/ped.15231.

DOI:10.1111/ped.15231

PMID:35831247

Abstract

BACKGROUND

We evaluated the significance of perinatal plasma natriuretic peptide (NP) levels in neonates with congenital heart defects (CHDs) or arrhythmias and determined whether measurement of perinatal plasma NP levels and echocardiographic assessment in utero could predict heart failure after birth.

METHODS

The study was conducted between 2012 and 2016 to evaluate the correlation of perinatal atrial NP (ANP) and brain NP (BNP) levels at birth with the modified Ross score after birth and the cardiovascular profile (CVP) score before birth.

RESULTS

A total of 122 singletons with CHDs or arrhythmias and 27 controls were analyzed. Neonatal blood sampling was performed at a median of 0.7 h (range, 0.1-1.5) after birth. The neonatal plasma ANP and BNP levels shortly after birth were significantly higher than those in the umbilical artery (UA) plasma. The ANP and BNP levels in UA and neonatal blood were correlated with the modified Ross score. The neonatal plasma ANP and BNP levels and the modified Ross scores were inversely correlated with the CVP score in neonates with CHDs or arrhythmias. The area under the receiver operating characteristic curve of UA ANP levels for predicting neonatal heart failure was highest among those for the CVP score, perinatal plasma ANP and BNP levels, and their combinations.

CONCLUSIONS

The plasma ANP and BNP levels increased markedly shortly after birth. Assessment of the UA plasma ANP level at birth and the CVP score in utero may be utilized to predict neonatal heart failure.

摘要

背景

我们评估了围产期血浆利钠肽（NP）水平在患有先天性心脏缺陷（CHD）或心律失常的新生儿中的意义，并确定围产期血浆 NP 水平的测量和宫内超声心动图评估是否可以预测出生后的心力衰竭。

方法

该研究于 2012 年至 2016 年进行，评估了出生时的心房利钠肽（ANP）和脑利钠肽（BNP）水平与出生后改良 Ross 评分和产前心血管状况（CVP）评分的相关性。

结果

共分析了 122 例患有 CHD 或心律失常的单胎和 27 例对照组。新生儿血液采样在出生后中位数 0.7 小时（范围 0.1-1.5）进行。新生儿出生后不久的血浆 ANP 和 BNP 水平明显高于脐动脉（UA）血浆。UA 和新生儿血液中的 ANP 和 BNP 水平与改良 Ross 评分相关。CHD 或心律失常新生儿的新生儿血浆 ANP 和 BNP 水平和改良 Ross 评分与 CVP 评分呈负相关。UA ANP 水平预测新生儿心力衰竭的受试者工作特征曲线下面积在 CVP 评分、围产期血浆 ANP 和 BNP 水平及其组合中最高。