血清sRAGE、YKL-40、MMP-16水平与新生儿呼吸窘迫综合征并发支气管肺发育不良的关系  

Relationship between serum sRAGE,YKL-40,MMP-16 levels and pulmonary dysplasia in neonatal respiratory distress syndrome and pulmonary dysplasia

作　　者：廖亮荣 刘文静[1] 吴学科[1] LIAO Liang-rong;LIU Wen-jing;WU Xue-ke(Department of Neonatal,Guigang People s Hospital,Guigang 537100,Guangxi,China)

机构地区：[1]贵港市人民医院新生儿科,广西贵港537100

出　　处：《川北医学院学报》2022年第10期1272-1275,共4页Journal of North Sichuan Medical College

基　　金：广西壮族自治区卫生健康委员会科研项目(Z20210793)。

摘　　要：目的:探讨血清可溶性晚期糖基化终末产物受体(sRAGE)、人软骨糖蛋白39(YKL-40)、基质金属蛋白酶-16(MMP-16)水平与新生儿呼吸窘迫综合征(NRDS)并发支气管肺发育不良(BPD)的关系。方法:选取180例NRDS患儿为研究对象,根据是否并发BPD分为BPD组(n=45)与非BPD组(n=135)。比较两组患儿性别、出生胎龄、出生体重、1 min Apgar、5 min Apgar、孕妇合并症(妊娠高血压、妊娠糖尿病、胎膜早破、产前感染、产前激素应用)、治疗方式[无创高频震荡通气(NHFOV)、经鼻持续正压通气(nCPAP)、经鼻间歇正压通气(niPPV)]、抗生素使用时间、机械通气时间、吸入氧浓度、输注红细胞悬液及血清YKL-40、sRAGE、MMP-16水平;ROC曲线分析血清YKL-40、sRAGE、MMP-16水平对NRDS并发BPD的预测价值;多因素Logistic回归分析NRDS并发BPD的危险因素。结果:BPD组患儿母亲产前感染、机械通气率、机械通气时间≥7 d、输注红细胞悬液百分比及血清sRAGE、MMP-16水平高于非BPD组(P<0.05);YKL-40水平低于非BPD组(P<0.05)。ROC曲线分析显示,血清sRAGE、YKL-40、MMP-16水平预测NRDS患儿并发BPD的AUC分别为0.744、0.826、0.903,最佳Cut-off值分别为55.67 ng/L、62.71 ng/mL、68.74 ng/mL,敏感度分别为70.3%、81.3%、88.7%,特异度分别为83.6%、82.5%、62.7%。产前感染、机械通气、机械通气时间≥7 d、输注红细胞悬液、sRAGE≥55.67 ng/L、YKL-40≤62.71 ng/mL、MMP-16≥68.74 ng/mL是NRDS患儿BPD发生的危险因素(P<0.05)。结论:NRDS患儿血清sRAGE、YKL-40、MMP-16水平是并发BPD的危险因素,可作为预测指标。Objective:To explore the relationship between serum soluble receptor for advanced glycation end products(sRAGE),human cartilage glycoprotein 39(YKL-40),and matrix Metalloproteinase-16(mmp-16)and neonatal respiratory distress syndrome(NRDS)and pulmonary dysplasia(BPD).Methods:180 children with NRDS were selected as the study subjects,and were divided into BPD group(n=45)and non BPD group(n=135)according to whether they were complicated with BPD.The sex,gestational age at birth,birth weight,1 min Apgar,5 min Apgar,maternal complications(pregnancy induced hypertension,pregnancy induced diabetes,premature rupture of membranes,prenatal infection,prenatal hormone use),treatment methods[noninvasive high frequency ventilation(NHFOV),nasal continuous positive airway pressure(nCPAP),nasal intermittent positive pressure ventilation(niPPV)],antibiotic use time,mechanical ventilation time,inhaled oxygen concentration,infusion of erythrocyte suspension and the serum levels of human cartilage glycoprotein 39(YKL-40),sRAGE and matrix metalloproteinase-16(MMP-16)were compared between the two groups.The ROC curve was drawn to analyze the predictive value of serum levels of YKL-40,sRAGE and MMP-16 on NRDS complicated with BPD.Multivariate Logistic regression was used to analyze the risk factors of NRDS complicated with BPD.Results:The prenatal infection,mechanical ventilation rate and mechanical ventilation time≥7d,the proportion of transfusion of erythrocyte suspension and the levels of sRAGE and MMP-16 in BPD group were higher than those in non BPD group,and YKL-40 was significantly lower than that in non BPD group(P<0.05).ROC curve analysis showed that SRAGE,YKL-40 and MMP-16 predicted the AUC of BPD in children with NRDS were 0.744,0.826 and 0.903,and the best Cut-off values were 55.67ng/L,62.71ng/mL and 68.74ng/mL respectively.At this time,the sensitivity was 70.3%,81.3%,88.7%,and the specificity was 83.6%,82.5%and 62.7%.Prenatal infection,mechanical ventilation,mechanical ventilation time≥7d,infusion of erythrocyte suspen

关 键 词：新生儿呼吸窘迫综合征 支气管肺发育不良 产前感染 可溶性晚期糖基化终末产物受体 人软骨糖蛋白39 基质金属蛋白酶-16 

分 类 号：R725.6[医药卫生—儿科]