摘要
目的:探讨新生儿呼吸窘迫综合征(NRDS)血清补体C1q-肿瘤坏死因子相关蛋白3(CTRP3)、骨形态发生蛋白-7(BMP-7)及呼吸末二氧化碳分压(PetCO2)对机械通气撤机的预测价值.方法:选取80例NRDS患儿为研究对象,依据撤机结局分为成功组54例、失败组26例.比较2组基线资料.分析不同组、不同严重程度患儿PetCO2、血清CTRP3、BMP-7水平,分析其与生化指标、疾病严重程度相关性.评价PetCO2、血清CTRP3、BMP-7对撤机结局的预测价值.采用SPSS24.0对数据进行分析,计数资料采用x2检验,计量资料采用t检验.结果:治疗 12h、24 h 后成功组 PetCO2分别为(36.32±1.88)(mmHg)4、(33.06±1.79)(mmHg)4,血清BMP-7 水平分别为(44.03±5.17)pg/mL、(41.16±4.88)pg/mL,血清 CTRP3 水平分别为(345.59±60.03)μg/L、(377.41±75.80)μg/L;治疗 12h、24 h 后失败组 PetCO2分别为(38.62±1.93)(mmHg)4、(38.57±1.90)(mmHg)4,血清 BMP-7 水平分别为(48.82±5.96)pg/mL、(48.39±5.63)pg/mL,血清 CTRP3 水平分别为(316.68±55.56)μg/L、(320.03±66.67)μg/L,治疗 12h、24h后成功组 PetCO2、血清 BMP-7 水平低于失败组,血清CTRP3水平高于失败组(P＜0.05);PetCO2、BMP-7与PaO2呈负相关,且与PaCO2、SNAPPE-Ⅱ评分、TGF-β1、IL-6、TNF-a、病情严重程度呈正相关,而CTRP3 与之相反(P＜0.05);治疗12h、24h后血清CTRP3、BMP-7及PetCO2联合预测撤机结局的AUC大于单项预测(P＜0.05).结论:血清CTRP3、BMP-7及PetCO2对NRDS患儿撤机结局预测具有应用价值.
Abstract
Objective:To investigate the predictive value of serum complement C1Q-tumor necrosis factor-associated protein 3(CTRP3),bone morphogenetic protein-7(BMP-7)and end-respiratory partial pressure of carbon dioxide(PetCO2)in mechanical ventilation of Neonatal respiratory distress syndrome(NRDS).Methods:A total of 80 children with NRDS were selected as research objects,and were divided into successful group(54 cases)and failed group(26 cases)according to the outcome of withdrawal.Two groups of baseline data were compared.The levels of PetCO2,serum CTRP3 and BMP-7 in children with different severity in different groups were analyzed,and their correlation with biochemical indexes and disease severity was analyzed.To evaluate the predictive value of PetCO2,serum CTRP3 and BMP-7 on the outcome of withdrawal.SPSS24.0 was used to analyze the data,x2 test was used for counting data and t test was used for measurement data.Results:After 12 h and 24 h treatment,the levels of PetCO2 in the successful group were(36.32±1.88)(mmHg)4 and(33.06±1.79)(mmHg)4,and the levels of serum BMP-7 were(44.03±5.17)pg/mL and(41.16±4.88)pg/mL,respectively.Serum CTRP3 levels were(345.59±60.03)μg/L and(377.41±75.80)μg/L,respectively.In the failure group after 12 h and 24 h treatment,the PetCO2 levels were(38.62±1.93)(mmHg)4 and(38.57±1.90)(mmHg)4,and the serum BMP-7 levels were(48.82±5.96)pg/mL and(48.39±5.63)pg/mL,respectively.The serum CTRP3 levels were(316.68±55.56)μg/L and(320.03±66.67)μg/L,respectively.After 12 h and 24 h treatment,the levels of PetCO2 and BMP-7 in successful group were lower than those in failure group,and the serum CTRP3 levels were higher than those in failure group(P＜0.05).PetCO2 and BMP-7 were negatively correlated with PaO2,and positively correlated with PaCO2,SNAPPE-Ⅱ score,TGF-β 1,IL-6,TNF-α and severity of disease,while CTRP3 were negatively correlated with it(P＜0.05).After 12 h and 24 h treatment,the AUC of serum CTRP3,BMP-7 and PetCO2 combined predicted the outcome of withdrawal was greater than that of single prediction(P＜0.05).Conclusion:Serum CTRP3,BMP-7 and PetCO2 are useful in predicting the outcome of children with NRDS.
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