肌腱蛋白C对支气管肺发育不良诊断价值的前瞻性研究  

Prospective study on the diagnostic value of tenascin C in bronchopulmonary dysplasia

作　　者：胡晶晶 郑亚斐 朱海艳 包天平[1] 程怀平[1] 田兆方[1] HU Jingjing;ZHENG Yafei;ZHU Haiyan;BAO Tianping;CHENG Huaiping;TIAN Zhaofang(Department of Neonatology,the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University,Huai’an Key Laboratory of Diagnosis and Treatment of Pediatric Respiratory Diseases,Huai’an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院新生儿科,淮安市小儿呼吸诊疗重点实验室,江苏淮安223300

出　　处：《南京医科大学学报（自然科学版）》2023年第4期531-535,562,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省卫健委妇幼健康科研项目重点课题(F201909);江苏省卫健委医学科研重点项目(ZDB2020005)。

摘　　要：目的:探讨血清肌腱蛋白C(tenascin C,TNC)对早产儿支气管肺发育不良(bronchopulmonary dysplasia,BPD)的诊断价值。方法:选择2018—2020年南京医科大学附属淮安第一医院新生儿科79例极低出生体重早产儿,根据美国国家儿童健康和人类发育研究所诊断标准分为非BPD组(n=48)和BPD组(n=31)。ELISA法检测血清TNC水平;多因素Logistic回归分析BPD发生的独立危险因素;Kendall相关分析血清TNC水平与BPD严重程度的相关性;绘制TNC诊断BPD的受试者工作特征(receiver operating characteristic,ROC)曲线。结果:①早产儿血清TNC水平在非BPD组与BPD组间差异有统计学意义[(95.03±19.73)ng/mL vs.(125.40±19.34)ng/mL,P<0.001],不同级别BPD组间差异有统计学意义(P<0.001);②早产儿发生BPD的独立危险因素包括出生体重、高浓度氧吸入时间及血清TNC水平(P<0.05);③血清TNC水平与BPD严重程度呈正相关(r=0.617,P<0.001);④血清TNC诊断BPD的ROC曲线下面积为0.881(P<0.001),灵敏度为96.8%,特异度为66.7%。结论:血清TNC水平在BPD中增高,诊断的灵敏度及特异度较高,可作为判断早产儿BPD的标志物之一。Objective:To explore the diagnostic value of serum tenascin C(TNC)in bronchopulmonary dysplasia(BPD)of the premature infants.Methods:Seventy⁃nine very low birth weight premature infants were enrolled from Department of Neonatology,the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University from 2018 to 2020.According to the 2018 NICHD diagnostic criteria,they were divided into the non⁃BPD group(n=48)and the BPD group(n=31).ELISA was used to detect serum TNC level;Multivariate logistic regression was conducted to analyze the independent risk factors of BPD;The correlation between serum TNC level and the severity of BPD was analyzed by Kendall correlation;Receiver operating characteristic(ROC)curve of TNC for diagnosis of BPD was made.Results:①The serum TNC level of preterm infants was statistically different between the non⁃BPD group and the BPD group[(95.03±19.73)ng/mL vs.(125.40±19.34)ng/mL,P<0.001],and there was statistical difference between different levels of BPD groups(P<0.001).②The independent risk factors for BPD in premature infants included birth weigh,high concentration oxygen inhalation time and serum TNC level(P<0.05).③Serum TNC level was positively correlated with the severity of BPD(r=0.617,P<0.001).④The area under the curve for the diagnosis of BPD by serum TNC was 0.881(P<0.001),the sensitivity was 96.8%,and the specificity was 66.7%.Conclusion:Serum TNC level increases in BPD,and the diagnostic sensitivity and specificity is high,which can be used as one of the biomarkers for diagnosis of premature BPD.

关 键 词：肌腱蛋白C 早产儿 极低出生体重儿 支气管肺发育不良 标志物 

分 类 号：R725.6[医药卫生—儿科]