目的:探讨血浆氨基末端脑钠肽前体(NT-proBNP)和胱抑素C(Cys-C)在诊断早产儿支气管肺发育不良(BPD)合并肺动脉高压(PH)中的应用价值.方法:选取2021年6月至2022年12月在江西省妇幼保健院NICU住院治疗的BPD早产儿,将其中合并PH的患儿设为试验组(27例),随机选择未合并PH者设为对照组(36例).收集所有患儿的血浆NT-proBNP和Cys-C水平进行对比分析,并总结血浆NT-proBNP和Cys-C水平对BPD合并PH的预测价值.结果:试验组出生后7 d和14 d的血浆NT-proBNP水平均显著高于对照组(P＜0.001),而Cys-C水平则显著低于对照组(P＜0.001).通过受试者工作特征(ROC)曲线分析显示,出生后14 d血浆NT-proBNP水平预测早产儿BPD合并PH的最佳截断值为357.39 pg/mL,曲线下面积(AUC)为0.958,灵敏度为92.59%,特异度为91.67%,最大约登指数为0.843;出生后7 d Cys-C水平预测早产儿BPD合并PH的最佳截断值为1.41 mg/L,AUC为0.858,灵敏度为77.78%,特异度为87.30%,最大约登指数为0.722.结论:血浆NT-proBNP和Cys-C对于诊断早产儿BPD合并PH具有较高的价值,可作为评估病情严重程度和预测预后的有效指标.
The application value of plasma N-terminal pro-brain natriuretic peptide and cystatin C in the diagnosis of bronchopulmonary dysplasia combined with pulmonary arterial hypertension in premature infants
Objective:To explore the clinical value of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)and cystatin C(Cys-C)in the diagnosis of bronchopulmonary dysplasia(BPD)combined with pulmonary arterial hypertension(PH)in premature infants.Methods:Premature infants with BPD who were hospitalized in the NICU of Jiangxi Maternal and Child Health Hospital from June 2021 to December 2022 were selected.Among them,those who were combined with PH were selected as the experimental group(27 cases),and those without PH were randomly selected as the control group(36 cases).The plasma NT-proBNP and Cys-C levels of all Child patients were collected for comparative analysis,and the predictive value of plasma NT-proBNP and Cys-C levels for BPD combined PH was summarized.Results:The plasma NT-proBNP levels at 7 and 14 days after birth in the experimental group were significantly higher than those in the control group(P<0.001),while the Cys-C levels were significantly lower than those in the control group(P<0.001).According to receiver operating characteristic(ROC)curve analysis,the optimal cut-offvalue for predicting premature infants'BPD combined with PH based on plasma NT-proBNP levels at 14 days after birth was 357.39 pg/mL,with an area under the curve(AUC)of 0.958,sensitivity of 92.59%,specificity of 91.67%,and maximum Jordan index of 0.843;The optimal cuto-ffvalue for predicting premature infants with BPD and PH based on Cys-C levels at 7 days after birth was 1.41 mg/L,AUC was 0.858,sensitivity was 77.78%,specificity was 87.30%,and maximum Youden index was 0.722.Conclusion:Plasma NT-proBNP and Cys-C have high value in diagnosing premature infants with BPD combined with PH,and can be used as effective indicators to evaluate the severity of the disease and predict prognosis.
万方数据
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