KL-6联合CC16检测对极早产儿支气管肺发育不良的预测价值  

Predictive value of KL-6 combined with CC16 for bronchopulmonary dysplasia in extremely preterm infants

作　　者：王奇蕾 舒桂华[1] 赵雪琴[1] 秦巧稚 WANG Qilei;SHU Guihua;ZHAO Xueqin;QIN Qiaozhi(Pediatric department,Northern Jiangsu People′s Hospital,Yangzhou,Jiangsu 225000,China)

机构地区：[1]江苏省苏北人民医院儿科,江苏扬州225000

出　　处：《国际检验医学杂志》2023年第14期1718-1722,共5页International Journal of Laboratory Medicine

基　　金：江苏省妇幼保健协会2021年度立项科研项目(FYX202022)。

摘　　要：目的探讨涎液化糖链抗原6(KL-6)联合Clara细胞分泌蛋白16(CC16)检测对极早产儿支气管肺发育不良(BPD)的预测价值。方法选择2019年7月至2022年6月在江苏省苏北人民医院出生的极早产儿(胎龄28~31+6周)112例,其中BPD组53(轻度27例,中、重度26例),非BPD组59例。收集其脐带血、出生后7 d及14 d的外周血,检测血清KL-6和CC16水平,用受试者工作特征(ROC)曲线下面积(AUC)分析KL-6、CC16预测BPD的灵敏度和特异度。结果与非BPD组相比,BPD组脐带血、出生后7 d及14 d外周血血清KL-6水平升高,CC16水平降低,两组之间差异均有统计学意义(P<0.001)。与轻度BPD组相比,中重度BPD组KL-6水平明显升高(P<0.05),CC16差异不明显(P>0.05)。二元Logistic分析发现极早产儿KL-6水平升高或CC16水平降低,发生BPD的风险增加(P<0.05)。ROC曲线提示出生后14 d血清KL-6、CC16水平对BPD的发生均有更好的独立预测能力(AUC分别为0.973、0.900,灵敏度分别为94.3%、88.1%,P<0.05),两者联合时预测价值更高(AUC为0.983,灵敏度为98.1%)。结论血清KL-6、CC16水平在预测极早产儿发生BPD中具有较高的可靠性,且KL-6的预测能力高于CC16,两种标志物联合检测能更好地预测BPD的发生发展。Objective To investigate the predictive characteristics of Krebs von den Lungen-6(KL-6)and Clara cell secretory protein 16(CC16)in bronchopulmonary dysplasia(BPD)of extremely preterm infants.Methods The study was conducted from July 2019 to June 2022,the subjects were extremely preterm infants with gestational age less than 32 week,fifty-one preterm infants were studied,of whom 53 were diagnosed with BPD(27 were diagnosed mild BPD and 26 were moderate/severe).Serum KL-6 and CC16 levels concentration were measured in cord blood plasma and were determined 7 and 14 days after birth to evaluate their value in the diagnosis of BPD,and the area under the curve(AUC)of Receiver operator characteristic(ROC)curve was used to analyze the sensitivity and specificity of KL-6 and CC16 for the diagnosis of BPD.Results Compared with non-BPD group,the serum KL-6 level in BPD group was increased,while the level of serum CC16 was decreased,and the differences were statistically significant(P<0.001).Compared with mild BPD group,the serum KL-6 level in BPD group was higher in moderate/severe BPD group(P<0.05),while the CC16 makes no sense(P>0.05).Through binary Logistic analysis we found increased KL-6 level or decreased CC16 level increased the risk of BPD,which was statistically significant(P<0.05).KL-6 and CC16 levels had better predictive ability for BPD at 2 weeks postnatal than that of cord blood and at 7days(area under ROC curve of receiver operation characteristics were 0.973 and 0.900,sensitivity were 94.3%and 88.1%,respectively,P<0.05),the combination of these markers enhanced the AUC further(area under ROC curve was 0.983,sensitivity was 98.1%).Conclusion The levels of serum KL-6 and CC16 have high reliability in predicting the occurrence of BPD among extremely preterm infants,and the predictive ability of KL-6 was higher than that of CC16.The combined detection of the two indicators can better predict the occurrence and development of BPD.

关 键 词：极早产儿 涎液化糖链抗原6 Clara细胞分泌蛋白16 支气管肺发育不良 肺损伤 生物学指标 

分 类 号：R722[医药卫生—儿科] R725[医药卫生—临床医学]