血清氨基末端脑钠肽前体及白细胞介素-6水平在新生儿呼吸窘迫综合征早期诊断和严重程度评估中的应用

目的 评估血清氨基末端脑钠肽前体(NT-proBNP)及白细胞介素(IL)-6水平在新生儿呼吸窘迫综合征(RDS)诊断和严重程度评估中的应用价值。方法 以2016年8月至2018年3月在南方医科大学附属中山博爱医院新生儿科住院治疗的150例RDS早产儿为研究对象(研究组),根据胸片成像再分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级;以同期住院的158例早产儿为对照(对照组)。分别于生后第1、3、7天检测血清NT-proBNP及IL-6水平,同时监测他们的肺动脉压(PAP)。结果 研究组生后第1(t=-91.04,P=0.000;t=-11.03,P=0.000)、3(t=-89.10,P=0.000;t=-9.909,P=0.000)及7天(t=-87.91,P=0.000;t=-8.548,P=0.000)的NT-proBNP和IL-6水平均明显高于对照组。各级RDS患儿生后第1(F=50.89,P=0.000)、3(F=49.16,P=0.000)、7天(F=45.45,P=0.000)的NT-proBNP水平差异有统计学意义,并呈逐级升高的趋势。各级RDS患儿生后第1(F=0.89,P=0.448)、3(F=0.76,P=0.518)、7天(F=0.85,P=0.469)的IL-6水平差异无统计学意义。研究组患儿生后第1、3、7天的PAP分别为(49.3±3.7)、(40.1±5.4)、(39.0±2.6)mmHg(1 mmHg=0.133 kPa),均明显高于对照组的(35.0±2.7)(t=-90.01,P=0.000)、(30.0±3.1)(t=-81.90,P=0.000)、(26.0±3.0)mmHg(t=-88.89,P=0.000)。相关性分析结果显示,NT-proBNP与IL-6(r=0.876,P=0.000)和PAP(r=0.916,P=0.000)均呈显著正相关。结论 监测血清NT-proBNP水平有助于RDS早产儿的早期诊断及严重程度评估。

Application of Serum Aminoterminal Pro-brain Natriuretic Peptide and Interleukin-6 Levels in Early Diagnosis and Severity Assessment of Preterm Infants with Respiratory Distress Syndrome

Objective To evaluate the value of serum aminoterminal pro-brain natriuretic peptide (NT-proBNP) and interleukin(IL)-6 levels in diagnosis and severity assessment of the preterm infants with respiratory distress syndrome(RDS).Methods Totally 150 preterm infants with RDS who were hospitalized in our center from August 2016 to March 2018 were enrolled in this study as the RDS group. These infants were further divided into grades Ⅰ,Ⅱ,Ⅲ,and Ⅳ according to chest radiography. In addition,158 preterm infants without RDS hospitalized in our center during the same period were included as the controls (control group). Serum NT-proBNP and IL-6 levels were measured by ELISA on days 1,3,and 7 after birth,and their pulmonary arterial pressure (PAP) was monitored as well.Results Serum NT-proBNP and IL-6 levels in RDS group were significantly higher than those in control group on day 1 (t=-91.04,P=0.000;t=-11.03,P=0.000),day 3 (t=-89.10,P=0.000;t=-9.909,P=0.000),and day 7 (t=-87.91,P=0.000;t=-8.548,P=0.000). There were significant differences in NT-proBNP levels among grades Ⅰ,Ⅱ,Ⅲ,and Ⅳ on day 1 (F=50.89,P=0.000),day 3 (F=49.16,P=0.000),and day 7 (F=45.45,P=0.000),showing an increasing trend. Serum IL-6 levels showed no significant difference among grades Ⅰ,Ⅱ,Ⅲ,and Ⅳ on day 1 (F=0.89,P=0.448),day 3 (F=0.76,P=0.518),and day 7 (F=0.85,P=0.469). The PAP of the RDS group on days 1,3,and 7 was (49.3±3.7),(40.1±5.4),and (39.0±2.6)mmHg (1 mmHg=0.133 kPa),which were significantly higher than those of the control group (35.0±2.7)mmHg (t=-90.01,P=0.000),(30.0±3.1)mmHg (t=-81.90,P=0.000),(26.0±3.0)mmHg (t=-88.89,P=0.000). Thus,there was a positive correlation between NT-proBNP and IL-6 levels (r=0.876,P=0.000) and a positive correlation between NT-proBNP and PAP (r=0.916,P=0.000) in preterm infants with RDS.Conclusion Monitoring serum NT-proBN contributes to early diagnosis and disease severity assessment in preterm infants with RDS.