Application Of Brain Natriuretic Peptide In Severe Hand-Foot-Mouth Disease

Research background and purpose:Brain natriuretic peptide(BNP)is a polypeptide consisting of 32 amino acid residues.The Japanese scholar Sudoh first isolated it from pig brains in 1988 and later found that BNP is widely distributed in other parts such as the heart,the lungs,and the kidneys,etc.Current studies have found that BNP plays an important role in many diseases.There are few studies on BNP and hand-foot-mouth disease.Therefore,the first part of this study aims to explore the role of BNP in severe hand-foot-mouth disease.Circulatory failure and neurogenic pulmonary edema are the main causes of death from severe hand-foot-and-mouth disease.With the maturation of ventilators,some children still die from circulatory failure after controlling for neurogenic pulmonary edema.However,there is still a lack of early warning indicators for predicting circulatory failure.Therefore,the second part of this study mainly discusses the factors related to circulatory failure in critically ill hand,foot and mouth disease,and defines their impact on prognosis.This research can help clinicians diagnose early on the severity and the direction of the development of the disease and provide appropriate treatment in time to reduce the morbidity and mortality of the disease.Research objects and research methods:The research objects are the 386 patients with HFMD who were hospitalized in Xi'an Children's Hospital from January 2015 to December 2017.According to the severity of the disease,the subjects were divided into the mild group(150 cases),the severe group(120cases),the critical group(80 cases)and the death group(36 cases).At the same time,100 healthy children in Xi'an Children's Hospital were selected as the control group.First of all,to detect the levels of plasma BNP of acute phase and convalescent phase(except death group)in the control group and the cases groups,analyze the differences of BNP levels between different groups in different period,and clear the critical value of the levels of BNP between the mild HFMD and the severe HFMD.At the same time,116 cases of critical group and death group detected left ventricular ejection fraction?heart rate?blood pressure?creatine kinase isoenzyme?high-sensitivity troponin?oxygen partial pressure and oxygen index,and the differences of above indexes between the two groups were compared.Research result:1)The difference of BNP level between the case group and the control group was statistically significant in the acute phase of the disease.The level of BNP in the death group was significantly higher than that in the critical group,the severe group and the mild group,and the difference was statistically significant.The level of BNP in critical group was significantly higher than that in the severe group and the mild group,and BNP level in severe group was significantly higher than that in the mild group,and the differences were statistically significant.In addition,the level of BNP in the recovery period of the case group was significantly lower than that in the acute phase,and the difference was statistically significant.There was no significant difference of the level of BNP between the control group and the recovery period of the case group.2)According to the ROC curve of BNP in mild hand foot and mouth disease and severe hand foot and mouth disease,the critical value of BNP in mild hand foot and mouthdisease and severe hand foot and mouth disease was 189.4pg / ml,and it's sensitivity was84% and the specificity was 82%.3)There was no significant difference between the critical group and the death group of creatine kinase isoenzyme,high-sensitivity troponin,oxygen partial pressure and oxygenation index.The difference of left ventricular ejection fraction,BNP,heart rate,blood pressure levels between the two groups were statistically significant.Research conclusion:1)The level of BNP is proportional to the severity of the disease.The more severe the disease is,the higher the BNP level is.And when BNP was 189.4pg / ml,it suggests that severe HFMD has the potential to develop into severe disease.The levels of BNP not only help to determine the severity of the disease but also play an important role in prognosis evaluation.2)Abnormal heart rate,blood pressure,BNP and LVEF often indicate poor prognosis in patients with severe hand-foot-mouth disease.They are the vital factors for circulatory failure and even death in patients with severe hand-foot-mouth disease.