The Application Value Of Ultrasonic Cardiac Output Monitor Combined With Brain Natriuretic Peptide In Infant Pneumonia With Heart Failure

Objective:To observe the application value of ultrasonic cardiac output monitor combined with brain natriuretic peptide in infant pneumonia with heart failure.Methods:25 cases(15 males and 10 females)of children with pneumonia complicated with heart failure from the department of pneumology and critical intensive care unit in kunming children's hospital from June,2018 to March,2019 were selected,the age was from two months to eleven months,the average age was 5.50±2.67 months(pneumonia with heart failure group).30 cases(17 males and 13 females)of children with ordinary pneumonia:the age was from two one month to ten months,the average age was 5.17±2.77 months(ordinary pneumonia group);30 healthy children were selected during the same period from outpatient department:13 males and 17 females,the age was from two months to eleven months,the average age was 5.56 ±2.52 months(healthy group).The peripheral bloods of 4ml to 6ml was takened from each group to detect the level of brain natriuretic peptide(BNP)by fluorescence immunoassay,the hypersensitive troponin T(hs-cTnT)level and interleukin-6(IL-6)level were detected by electrochemilu minescene immunoassay.The levels of serum BNP,hs-cTnT and IL-6 in the three groups were compared.All the children were used the USCOM to monitor the related hemodaynamics datas,including the cardiac output(CO),stroke volume(SV),cardiac index(CI),peripheral vascular resistance(SVR).The level of USCOM related data in the three groups were compared and analyzed,then observe the changes of USCOM related hemodaynamics datas in the pneumonia with heart failure group after treatment.In order to investigate the application value of USCOM combined with BNP in infant pneumonia with heart failure,using the receiver operating characteristic curve not only to analyze the diagnostic value of USCOM combined with BNP but also to anlyze the correlation between USCOM and BNP.Results:1.The level of serum BNP was[(123.64±79.37)pg/ml],hs-cTnT was[(91.07±93.85)pg/ml]and IL-6 was[(19.23±27.09)pg/ml]in the pneumonia complicated with heart failure group.lt was significantly compared with ordinary pneumonia and healthy group,with statistical significance(P<0.05).The levels of CO,SV,CI and SVR in the pneumonia complicated with heart failure group were[(1.19±0.27)]1/min),[(7.40±1.76)ml],[(4.48±0.86)l/min/m2],[(4487.48 ±1251.28)d.s.cm-5],with statistical significance.(P<0.05).Before treatment,the levels of CO,SV,CI and SVR in children with pneumonia complicated with heart failure were[(1.19±0.27)]l/min),[(7.40±1.76)ml],[(4.48±0.86)l/min/m2],[(4487.48±1251.28)d.s.cm-5].After treatment,the levels of CO,SV,CI and SVR were[(1.42 ±0.26)l/min],[(10.48±1.57)ml],[(4.62±0.77)l/min/m2],[(3909.88±927.03)d.s.cm-5].The results showed that the related datas of USCOM were improved after treatment,with statistical significance(P<0.01).3.The area under ROC curve of CO?CI?SV?SVR?BNP for pneumonia with heart failure was 0.873?0.943?0.673?0.731?0.993(P<0.01?<0.01?=0.012?=0.001?<0.01).The area under ROC curve of USCOM comnbined with BNP was 0.997,showed a sensitivity of 96.0%and a specificity of 96.7%to diagnose infant pneumonia with heart failure.There were linear negative correlationg not only between BNP and CO but also between with BNP and SV(r=-0.502-0.579,P<0.01).Conclusions:1.The level of serum BNP can be used as an objective laboratory,data for the diagnosis of infant pneumonia with heart failure,to identify the ordinary pnenumonia and pneumonia with heart failure.2.USCOM can be used as a hemodynamic examination technology to monitor the hemodaynamic changs in pneumonia with heart failure,reflect the heart function and evaluate the treatment.3.USCOM combined with BNP detection may improve the level of clinical diagnosis of infant pneumonia with heart failure for early diagnosis and learn the patient's hemodynamic situation as soon as possible then to give timely intervention,reduce the mortality rate of pnenumonia with heart failure in pediatic.