Dynamic Changes of Serum NG AL in Premature Infants with Respiratory Distress Syndrome and Its Early Predictive Value for the Occurrence of Bronchopulmonary Dysplasia
Objective To investigate the dynamic changes of serum neutrophil gelatinase-associated lipid carrier protein(NGAL)in premature infants with respiratory distress syndrome,and analyze its early predictive value for the occurrence of bronchopulmonary dysplasia(BPD)in children.Methods The prospective cohort study method was used to select 81 premature infants with respiratory distress syndrome from August 2019 to January 2023 in the Department of Pediatrics of Pingdingshan First People's Hospital as the research object.Serum NGAL levels were measured within 24 hours after birth,3,7 and 14 days after birth,and baseline data were collected.According to whether BPD occurred 28 days after birth,the children were divided into the occurrence group and the non-occurrence group.The serum NGAL levels and baseline data at different time points were compared between the two groups.The relationship between the dynamic changes of serum NGAL and the occurrence of BPD in children with respiratory distress syndrome was tested by point two column correlation,and then the receiver operating characteristic(ROC)curve was drawn to analyze the early predictive value of the dynamic changes of serum NGAL on the occurrence of BPD in premature infants with respiratory distress syndrome.Results A total of 81 premature infants with respiratory distress syndrome were included in the study,including 1 dropout due to adverse outcomes and 1 dropout due to a parent's application to withdraw from the study.Finally,79 children completed the entire study.Among them,30 children developed BPD,with an incidence rate of 37.97％(30/79).The levels of tumor necrosis factor-α(TNF-α)and plasma type Ⅱ alveolar kerbs von lungren 6 antigen(KL-6)in the occurrence group were higher than those in the non-occurrence group(P＜0.05).There was no statistical difference in serum NGAL between the two groups of children within 24 hours of birth(P＞0.05).The serum NGAL levels of children in the 3,7 and 14 days after birth group were higher than those in the non-occurring group(P＜0.05).The use of point two column correlation test showed a positive correlation between serum NGAL levels,serum TNF-α and plasma KL-6 at 3,7 and 14 days of birth and the occurrence of BPD in children with respiratory distress syndrome(r＞0,P＜0.05).ROC characteristic showed that serum NGAL at 3 days after birth had a low predictive value for BPD in children with respiratory distress syndrome,with an area under the curve(AUC)of 0.643,while serum NGAL at 7 days after birth had a moderate predictive value for BPD in children,with an AUC of 0.866.The serum NGAL at 14 days after birth had a high predictive value for the occurrence of BPD in children,with an AUC of 0.935.Conclusion The dynamic changes of serum NGAL have certain predictive value for the occurrence of BPD in children with respiratory distress syndrome,and the predictive value is highest at 14 days after birth.
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