血清相关细胞因子水平变化与PPHN患儿疾病转归的相关性及动态监测临床意义  

The correlation between changes of serum-related cytokine levels and disease outcome in children with PPHN and the clinical significance of dynamic monitoring

作　　者：郝玉贵 周江平 Hao Yu-gui;Zhou Jiang-ping(Department of Neonatology,Yanjin County People's Hospital,Xinxiang 453200,Henan,China)

机构地区：[1]延津县人民医院新生儿科,河南新乡453200

出　　处：《四川生理科学杂志》2022年第4期605-607,709,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:观察血清相关细胞因子水平变化与新生儿持续肺动脉高压(Persistent pulmonary hypertension of the newborn,PPHN)患儿疾病转归的相关性及动态监测临床意义。方法:选取2018年2月~2020年8月我院收治的74例PPHN患儿作为研究对象,按照肺动脉收缩压/体循环收缩压(Systolic pulmonary artery pressure/systolic blood pressure,sPAP/sBP)分为重度组(n=36)和轻中度组(n=38),另选同期健康新生儿40例作为健康组,均采用酶联免疫吸附法测定血清转化生长因子β1(Transforming growth factorβ1,TGF-β1)、B型利钠肽(B-type natriuretic peptide,BNP)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)水平,对比不同病情程度PPHN患儿及健康组血清TGF-β1、BNP、VEGF水平,生存组、病死组血清学指标水平,分析其与疾病转归相关性及预测价值。结果:PPHN患儿病情越严重,其血清TGF-β1、BNP、VEGF水平越高(P<0.05);第3、7、10 d重度组PPHN患儿血清TGF-β1、BNP、VEGF水平呈依次下降趋势(P<0.05);Pearson相关性分析显示,血清TGF-β1、BNP、VEGF水平与PPHN患儿sPAP/sBP呈正相关关系(P<0.05);血清TGF-β1、BNP、VEGF水平评估PPHN患儿不良预后的曲线下面积(Area under curve,AUC)、灵敏性、特异性均较高。结论:血清TGF-β1、BNP、VEGF水平与PPHN患儿sPAP/sBP呈正相关,通过检测这些因子水平变化可评估患儿病情及预后,有利于治疗方案制定。Objective:To observe the correlation between the changes of serum-related cytokine levels and the disease outcome of children with persistent pulmonary hypertension of the newborn(PPHN)and the clinical significance of dynamic monitoring.Methods:A total of 74 children with PPHN who were admitted to our hospital from February 2018 to August 2020 were selected and divided into severe group(n=36)and the mild-to-moderate group(n=38)according to systolic pulmonary artery pressure/systolic blood pressure(sPAP/sBP),and 40 healthy neonates during the same period were selected as the healthy group.The serum transforming growth factorβ1(TGF-β1)was determined by enzyme-linked immunosorbent assay.The levels of TGF-β1,B-type natriuretic peptide(BNP),and vascular endothelial growth factor(VEGF)were compared,and serum TGF-The levels ofβ1,BNP,VEGF,and the levels of serological indexes in the survival group and the death group were analyzed to analyze their correlation with disease outcome and their predictive value.Results:There were statistically significant differences in the levels of serum TGF-β1,BNP and VEGF in children with PPHN of different degrees of disease,and the more severe the disease,the higher the levels of serum TGF-β1,BNP and VEGF(P<0.05).The serum levels of TGF-β1,BNP,and VEGF in children with PPHN on the 10th day in the severe group showed a decreasing trend(P<0.05).The relationship between the two groups(P<0.05);serum TGF-β1,BNP and VEGF levels were high in the area under the curve(AUC),sensitivity and specificity for evaluating the poor prognosis of children with PPHN.Conclusion:The levels of serum TGF-β1,BNP,and VEGF are positively correlated with sPAP/sBP in children with PPHN.The changes in the levels of related factors can be used to evaluate the condition and prognosis of children,which is conducive to the formulation of treatment plans.

关 键 词：新生儿持续肺动脉高压 转化生长因子β1 B型利钠肽 血管内皮生长因子 动态监测 

分 类 号：R72[医药卫生—儿科]