{"title":"n端前脑利钠肽（NT-proBNP）与心肌肌钙蛋白I （cTnI）联合检测对肺炎支原体肺炎患儿心肌损伤的诊断价值","authors":"Mei Yang, Aili Xuan, Guoji Zhu","doi":"10.2147/JMDH.S527700","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic performance of combined N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) testing for myocardial injury in children with Mycoplasma pneumoniae pneumonia (MPP).</p><p><strong>Methods: </strong>This retrospective study included 103 pediatric patients with MPP complicated by myocardial injury admitted between December 2021 and December 2023. Patients were stratified by New York Heart Association (NYHA) functional class (I-IV). Demographic and clinical characteristics, biomarker levels, and diagnostic accuracy were analyzed. ROC curves were used to assess diagnostic performance of single and combined biomarkers.</p><p><strong>Results: </strong>No significant differences were observed in age or gender across NYHA classes. However, BMI Z-scores declined significantly with worsening class (P = 0.013), while heart rate, systolic blood pressure, fever duration, respiratory rate, and hospital stay increased progressively (all P < 0.01), indicating disease severity. Serum NT-proBNP and cTnI levels rose in parallel with advancing NYHA class (P < 0.001 between all adjacent groups). A strong positive correlation was found between NT-proBNP and cTnI (r = 0.617, P < 0.001). Combined biomarker testing demonstrated superior diagnostic accuracy (AUC = 0.914), outperforming NT-proBNP (AUC = 0.877) and cTnI alone (AUC = 0.739). The combination improved sensitivity (94.15%) and specificity (95.19%), reducing false negatives and enhancing risk stratification. Notably, 80% of NYHA class III-IV cases were correctly reclassified into the high-risk group, with a net reclassification improvement (NRI) of +34.2% (P = 0.002).</p><p><strong>Conclusion: </strong>Combined NT-proBNP and cTnI testing provides robust diagnostic efficacy for myocardial injury in pediatric MPP. This dual-biomarker strategy enables earlier identification of high-risk patients and supports more precise clinical management.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3709-3716"},"PeriodicalIF":2.4000,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210056/pdf/","citationCount":"0","resultStr":"{\"title\":\"Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with <i>Mycoplasma</i> Pneumoniae Pneumonia.\",\"authors\":\"Mei Yang, Aili Xuan, Guoji Zhu\",\"doi\":\"10.2147/JMDH.S527700\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the diagnostic performance of combined N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) testing for myocardial injury in children with Mycoplasma pneumoniae pneumonia (MPP).</p><p><strong>Methods: </strong>This retrospective study included 103 pediatric patients with MPP complicated by myocardial injury admitted between December 2021 and December 2023. Patients were stratified by New York Heart Association (NYHA) functional class (I-IV). Demographic and clinical characteristics, biomarker levels, and diagnostic accuracy were analyzed. ROC curves were used to assess diagnostic performance of single and combined biomarkers.</p><p><strong>Results: </strong>No significant differences were observed in age or gender across NYHA classes. However, BMI Z-scores declined significantly with worsening class (P = 0.013), while heart rate, systolic blood pressure, fever duration, respiratory rate, and hospital stay increased progressively (all P < 0.01), indicating disease severity. Serum NT-proBNP and cTnI levels rose in parallel with advancing NYHA class (P < 0.001 between all adjacent groups). A strong positive correlation was found between NT-proBNP and cTnI (r = 0.617, P < 0.001). Combined biomarker testing demonstrated superior diagnostic accuracy (AUC = 0.914), outperforming NT-proBNP (AUC = 0.877) and cTnI alone (AUC = 0.739). The combination improved sensitivity (94.15%) and specificity (95.19%), reducing false negatives and enhancing risk stratification. Notably, 80% of NYHA class III-IV cases were correctly reclassified into the high-risk group, with a net reclassification improvement (NRI) of +34.2% (P = 0.002).</p><p><strong>Conclusion: </strong>Combined NT-proBNP and cTnI testing provides robust diagnostic efficacy for myocardial injury in pediatric MPP. This dual-biomarker strategy enables earlier identification of high-risk patients and supports more precise clinical management.</p>\",\"PeriodicalId\":16357,\"journal\":{\"name\":\"Journal of Multidisciplinary Healthcare\",\"volume\":\"18 \",\"pages\":\"3709-3716\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210056/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Multidisciplinary Healthcare\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/JMDH.S527700\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Multidisciplinary Healthcare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JMDH.S527700","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with Mycoplasma Pneumoniae Pneumonia.
Objective: To evaluate the diagnostic performance of combined N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) testing for myocardial injury in children with Mycoplasma pneumoniae pneumonia (MPP).
Methods: This retrospective study included 103 pediatric patients with MPP complicated by myocardial injury admitted between December 2021 and December 2023. Patients were stratified by New York Heart Association (NYHA) functional class (I-IV). Demographic and clinical characteristics, biomarker levels, and diagnostic accuracy were analyzed. ROC curves were used to assess diagnostic performance of single and combined biomarkers.
Results: No significant differences were observed in age or gender across NYHA classes. However, BMI Z-scores declined significantly with worsening class (P = 0.013), while heart rate, systolic blood pressure, fever duration, respiratory rate, and hospital stay increased progressively (all P < 0.01), indicating disease severity. Serum NT-proBNP and cTnI levels rose in parallel with advancing NYHA class (P < 0.001 between all adjacent groups). A strong positive correlation was found between NT-proBNP and cTnI (r = 0.617, P < 0.001). Combined biomarker testing demonstrated superior diagnostic accuracy (AUC = 0.914), outperforming NT-proBNP (AUC = 0.877) and cTnI alone (AUC = 0.739). The combination improved sensitivity (94.15%) and specificity (95.19%), reducing false negatives and enhancing risk stratification. Notably, 80% of NYHA class III-IV cases were correctly reclassified into the high-risk group, with a net reclassification improvement (NRI) of +34.2% (P = 0.002).
Conclusion: Combined NT-proBNP and cTnI testing provides robust diagnostic efficacy for myocardial injury in pediatric MPP. This dual-biomarker strategy enables earlier identification of high-risk patients and supports more precise clinical management.
期刊介绍：
The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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