新生儿持续肺动脉高压患儿血清CXCL8、CXCL12与一氧化氮吸入治疗临床转归的关系  

Relationship Between Serum CXCL8,CXCL12 and Clinical Outcome of Nitric Oxide Inhalation Therapy in Persistent Pulmo-nary Hypertension Neonates of the Newborn

作　　者：闫晓燕 司鑫 权艳华[1] 焦东菊 翟淑芬[1] YAN Xiaoyan;SI Xin;QUAN Yanhua;JIAO Dongju;ZHAI Shufen(Department of Neonatology in East District,Handan Central Hospital,Handan Hebei 056000,China)

机构地区：[1]河北省邯郸市中心医院东区新生儿科,河北邯郸056000

出　　处：《联勤军事医学》2024年第1期26-30,共5页Military Medicine of Joint Logistics

基　　金：河北省2020年度医学科学研究课题计划(20200454)。

摘　　要：目的探讨新生儿持续肺动脉高压(persistent pulmonary hypertension of newborn,PPHN)患儿血清人CXC型趋化因子配体8(C-X-C motif chemokine ligand 8,CXCL8)、CXCL12与一氧化氮吸入治疗临床转归的关系。方法选择2021-08/2023-05月作者医院收治并给予一氧化氮吸入治疗的PPHN患儿135例为研究对象。根据患儿出院时临床转归结局分为死亡组(n=32)和存活组(n=103)。比较两组PPHN患儿血清CXCL8、CXCL12水平。单因素及多因素Logistic回归模型分析接受一氧化氮吸入治疗PPHN患儿临床转归的影响因素。受试者工作特征(receiver operating characteristic,ROC)曲线分析血清CXCL8、CXCL12对接受一氧化氮吸入治疗PPHN患儿临床转归的预测价值。结果死亡组患儿血清CXCL8、CXCL12水平显著高于存活组(P均<0.05)。多因素Logsitic回归分析结果显示,血清CXCL8水平升高、血清CXCL12水平升高、早产、出生时Apgar评分0~3分、合并并发症是接受一氧化氮吸入治疗的PPHN患儿死亡的危险因素,肺表面活性物质应用、吸入一氧化氮早期反应则是保护因素(P<0.05)。ROC曲线分析结果显示,血清CXCL8、CXCL12联合检测对接受一氧化氮吸入治疗的PPHN患儿死亡预测的曲线下面积(area under the curve,AUC)为0.828,大于血清CXCL8、CXCL12单独检测(AUC分别为0.762、0.714)。结论PPHN患儿血清CXCL8、CXCL12水平升高与接受一氧化氮治疗的不良临床转归有关,且CXCL8、CXCL12水平升高是PPHN患儿死亡的危险因素。CXCL8、CXCL12联合检测对接受一氧化氮治疗PPHN患儿死亡具有较高的预测价值。Objective To investigate the relationship of clinical outcome between serum C-X-C motif chemokine lig-and 8(CXCL8),CXCL12 and nitric oxide inhalation therapy in persistent pulmonary hypertension of newborn(PPHN).Methods A total of 135 PPHN children who were treated with nitric oxide inhalation in author's hospital from August 2021 to May 2023 were selected as study subjects.The children were divided into death group(n=32)and survival group(n=103)according to the clinical outcome at discharge.The levels of serum CXCL8 and CXCL12 in PPHN children were compared between two groups.The influencing factors of clinical outcomes in PPHN children treated with nitric oxide in-halation were analyzed by univariate and multivariate Logistic regression models.The predictive value of serum CXCL8 and CXCL12 on the clinical outcome of PPHN children treated with nitric oxide inhalation were analyzed by receiver oper-ating characteristic(ROC)curve.Results The levels of serum CXCL8 and CXCL12 in PPHN children in death group were significantly higher than those in survival group(all P<0.05).Multivariate Logsitic regression analysis showed that,elevated serum CXCL8 level,elevated serum CXCL12 level,premature delivery,Apgar score 0-3 at birth and the complications were risk factors for death in PPHN children receiving nitric oxide inhalation therapy;pulmonary surfactant application and early response to inhaled nitric oxide were protective factors(P<0.05).The results of ROC curve analy-sis showed that,the area under the curve(AUC)of combined detection of serum CXCL8 combined CXCL12 for predic-ting the death of PPHN children receiving nitric oxide inhalation therapy was 0.828,which was greater than that of serum CXCL8 and CXCL12 alone(AUC were 0.762 and 0.714 respectively).Conclusion The increase of serum CXCL8 and CXCL12 levels in PPHN children are related to the poor clinical outcome of nitric oxide treatment,and the increase of the two indicators are risk factors for the death of PPHN children.The combined detection of CXCL8 and CXCL

关 键 词：新生儿持续肺动脉高压 人CXC型趋化因子配体8 人CXC型趋化因子配体12 一氧化氮吸入治疗 临床转归 

分 类 号：R174.1[医药卫生—妇幼卫生保健]