早期早产儿血浆N末端脑钠肽参考值范围  

Reference range of plasma N-terminal pro-brain natriuretic peptide levels in early preterm infants

作　　者：张茜[1] 罗成汉[1] 时赞扬[1] 程欣茹[1] 徐千雅[1] 郭宏湘[1] 王丽[1] 程秀永[1] 盛光耀[1] 卢洁[2] 

机构地区：[1]郑州大学第一附属医院儿科,450052 [2]郑州大学公共卫生学院流行病与卫生统计学系

出　　处：《中华实用儿科临床杂志》2013年第2期98-101,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：河南省医学科技攻关计划项目（201202003）

摘　　要：目的制定早期早产儿血浆N末端脑钠肽（NT-proBNP）参考值范围。方法1．研究对象按下列标准纳入：（1）2009年10月至2012年8月出生后24h内入住郑州大学第一附属医院新生儿病房的早产儿；（2）母亲孕期健康；（3）家属签署知情同意书者；（4）出生当天血气分析、电解质、肝肾功能、心肌酶、血常规及传染病4项（乙肝、丙肝、梅毒及艾滋病）等实验室辅助检查无异常者。2．用电化学发光免疫法于出生后1d、3d、7d检测血浆NT-proBNP水平。变量资料选用Shapiro—Wilk检验法进行正态性检验，呈正态分布者用面±s表示。不同时间点早产儿NT—proBNP水平比较采用重复测量资料的方差分析；NT—proBNP表达的影响因素分析采用多重线性回归模型，参考值区间：包含95％的参考总体的参考值范围。双侧正态（均数法）：i±1．96s。检验水准均为a=0．05。结果1．共入选因早产和（或）出生体质量较低要求寄养的早产儿204例。男104例，女100例；胎龄27^＋1-36^＋6周（中位数33周）；出生体质量700—3050g（中位数1590g）；阴道分娩78例，剖宫产126例；血清胆红素水平（56．6±23．1）p,mol／L；母亲年龄为（30．6±5．3）岁；不同性别之间各项参数差异无统计学意义（P〉0．05）。2．出生后1d血浆NT—proBNP水平作为因变量，将性别、分娩方式、胎龄、出生体质量、营养方式、血清胆红素及母亲年龄作为潜在的影响因素，行多重线性回归分析，Enter法全部强迫引入，结果显示，以n=0．05为检验水准，均与NT—proBNP水平无相关性。3．早产儿204例血浆NT—proBNP水平出生后1d、3d,7d数据经Shapiro-Wilk正态检验均呈正态分布。经重复测量资料的方差分析：不同日龄血浆NT—proBNP水平差异有统计学意义（F=443．824，P=0．000）；出生后1d最高，之后随出生后日龄增加而降低，二者呈负相关（r=�Objective To establish the reference range of plasma N-terminal pro-brain natriuretic peptide （NT-proBNP） levels in early preterm infants. Methods 1. Inclusion criteria of the subjects： （ 1 ） preterm infants ad- mitted to Neonatal Ward of First Affiliated Hospital of Zhengzhou University between Oct. 2009 and Aug. 2012 within 24 hours after birth ; （ 2 ） maternal health during pregnancy; （ 3 ） written informed consent obtained from parents ; （ 4 ） normal laboratory examination results such as blood gas analysis, electrolyte, hepatorenal function, myocardial enzyme, routine blood count and infectious disease screening （hepatitis B, hepatitis C, syphilis and acquired immune deficiency syndrome） within 24 hours after birth. Plasma NT-proBNP levels were measured on day 1, day 3 and day 7 of life. Variable data was analyzed using the Shapiro-Wilk test for normality test. Difference in plasma NT-proBNP levels on different days of life was analyzed using repeated measure analysis of variance. A multiple regression analysis was per- formed to determine the influencing factors for plasma NT-proBNP level, reference value interval：reference range contai- ning 95 % of the reference population, namely （ $ - 1.96 s ） - （ $ ＋ 1.96 s ）, with inspection level a = 0.05. Results 1. A total of 204 preterm infants （104 cases were male and 100 cases were female） were included in the present study, with gestational age ranging from 27 ＋1 to 36.6 weeks（ median 33 weeks） and birth weight ranging from 700 to 3050 g （median 1590 g）. Of these preterm infants, vaginal delivery were 78 cases, cesarean delivery in 126 cases, serum biliru- bin level was （ 56.6 ＋ 23.1 ） p.mol/L, maternal age was （ 30.6 ＋ 5.3 ） years. There was no difference of these parame- ters between male and female （ P 〉 0.05 ）. 2. A multiple regression analysis was performed including following factors ： gender, delivery mode, gestational age, birth weight, alimentation mode, serum bilirubin, and matern

关 键 词：早期早产儿 血浆 N末端脑钠肽前体 参考值范围 

分 类 号：R722[医药卫生—儿科]