支气管肺发育不良早产儿血清Periostin、IL-18水平及临床意义  

Serum levels and clinical significance of Periostin and IL-18 in preterm infants with bronchopulmonary dysplasi

作　　者：李伟娜 郭秀亚 何仙 李研 马欢欢 付琳琳 郄学敏 LI Weina;GUO Xiuya;HE Xian;LI Yan;MA Huanhuan;FU Linlin;XI Xuemin(First Department of Neonatology,Baoding Maternal and Child Health Hospital,Baoding,Hebei 071000,China)

机构地区：[1]保定市妇幼保健院新生儿一科,河北保定071000

出　　处：《国际检验医学杂志》2024年第19期2366-2371,共6页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题计划(20191170);保定市科技计划项目(2341ZF120)。

摘　　要：目的研究血清骨膜蛋白(Periostin)、白细胞介素(IL)-18在支气管肺发育不良(BPD)早产儿中的水平,分析二者与病情严重程度的关系及对BPD的预测价值。方法回顾性选取2019年1月至2022年1月于该院诊治的62例BPD早产儿为BPD组,以同期80例非BPD早产儿为非BPD组。根据病情严重程度,将BPD组患儿分为轻度亚组22例,中度亚组24例和重度亚组16例。采用酶联免疫吸附试验检测血清Periostin、IL-18水平。各临床参数间的相关性采用Pearson相关分析。采用多因素Logistic回归分析BPD发生的影响因素,受试者工作特征(ROC)曲线分析各指标对BPD的预测价值。结果BPD组使用肺泡表面活性物质(PS)、新生儿呼吸窘迫综合征、呼吸暂停、动脉导管未闭占比及血清Periostin、IL-18水平高于非BPD组,机械通气时间、无创呼吸支持时间、住院时间长于非BPD组,而肺功能指标[千克体重潮气量(VT/kg)、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)、50%潮气量时呼气流速(50%TEF)、75%潮气量时呼气流速(75%TEF)]及1、5 min Apgar评分低于非BPD组,差异均有统计学意义(P<0.05)。轻度亚组、中度亚组及重度亚组患儿血清Periostin、IL-18水平依次升高(P<0.05)。血清Periostin、IL-18水平与肺功能指标(VT/kg、50%TEF、75%TEF、TPTEF/TE、VPEF/VE)均呈负相关(P<0.05)。早产儿血清Periostin、IL-18、新生儿呼吸窘迫综合征是影响BPD发生的独立危险因素(P<0.05),使用PS是保护因素(P<0.05)。早产儿血清Periostin、IL-18、新生儿呼吸窘迫综合征是影响BPD病情严重程度的独立危险因素(P<0.05)。血清Periostin、IL-18单独及联合对BPD预测的曲线下面积(95%CI)分别为0.841(0.814~0.899)、0.863(0.820~0.897)、0.922(0.878~0.949),联合预测的灵敏度和特异度分别为0.902、0.825;二者联合对BPD预测的曲线下面积大于各指标单独预测,差异有统计学意义(Z=5.357、4.894,均P<0.001)。结论BPD患儿血清Periostin、IL-18�Objective To study the levels of serum Periostin and interleukin(IL)-18 in preterm infants with bronchopulmonary dysplasia(BPD),and to analyze their correlation with the severity of the disease and their predictive value for BPD.Methods A total of 62 preterm infants with BPD diagnosed and treated in the hospital from January 2019 to January 2022 were retrospectively selected as the BPD group,and 80 preterm infants without BPD during the same period were selected as the non-BPD group.According to the severity of BPD,the infants with BPD were divided into mild subgroup(22 cases),moderate subgroup(24 cases)and severe subgroup(16 cases).The serum levels of Periostin and IL-18 were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between the clinical parameters.Multivariate Logistic regression was used to analyze the influencing factors of BPD,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of each indicator for BPD.Results Compared with the non-BPD group,the BPD group had a significantly higher proportion of infants with pulmonary surfactant(PS)use,neonatal respiratory distress syndrome,apnea,patent ductus arteriosus,and serum levels of Periostin and IL-18,as well as a significantly longer duration of mechanical ventilation,noninvasive respiratory support,and length of hospital stay.The lung function parameters[tidal volume per kilogram(VT/kg),ratio of time to peak tidal expiratory flow to time(TPTEF/TE),ratio of volume to peak tidal expiratory flow to volume(VPEF/VE),expiratory flow at 50%tidal volume(50%TEF),expiratory flow at 75%tidal volume(75%TEF)]and 1,5 min Apgar score of BPD group were lower than that of non-BPD group,and the differences were statistically significant(P<0.05).The serum levels of Periostin and IL-18 in mild subgroup,moderate subgroup and severe subgroup were increased in turn.The levels of serum Periostin and IL-18 were negatively correlated with pulmonary function indexes(VT/kg,50%TEF,75%TEF

关 键 词：支气管肺发育不良 骨膜蛋白 白细胞介素-18 早产儿 

分 类 号：R722.6[医药卫生—儿科]