血浆不对称二甲基精氨酸检测在早产儿支气管肺发育不良伴肺动脉高压诊断中的临床价值研究

Clinical value of plasma asymmetric dimethylarginine detection in diagnosis of bronchopulmonary dysplasia with pulmonary arterial hypertension in premature infants

目的探讨血浆不对称二甲基精氨酸检测在早产儿支气管肺发育不良伴肺动脉高压诊断中的临床价值。方法选择青海大学附属医院和青海省妇女儿童医院产科2015年11月~2017年4月收治的30例BPD早产儿为观察组,按是否并发PAH分为两组,BPD+PAH组(n=12)与BPD不伴PAH组(n=18),同时随机抽取同期住院无BPD的早产儿32例为对照组。比较三组早产儿不同日龄ADMA水平变化,生后14 d血浆ADMA、Arg、L-Arg/ADMA比值。结果三组早产儿出生时及生后7 d血浆ADMA值比较,差异无统计学意义(P>0.05);生后14 d血浆ADMA值比较差异有统计学意义(P<0.05)。组间两两比较,BPD伴PAH组分别与BPD不伴PAH组和对照组比较,差异均有统计学意义(t=2.39,2.62,P<0.05)。BPD不伴PAH组与对照组比较,差异无统计学意义(t=0.73,P>0.05)。生后14 d,BPD伴PAH组的血浆ADMA值分别高于BPD不伴PAH组和对照组(P<0.05);L-Arg/ADMA值均低于BPD不伴PAH组和对照组(P<0.01);三组早产儿L-Arg值比较,差异无统计学意义(P>0.05)。结论血浆不对称二甲基精氨酸检测在早产儿BPD伴PAH诊断中具有重要临床价值,血浆ADMA、L-Arg/ADMA与BPD伴PAH的发生密切相关,可作为疾病发生的预测性因子,值得推广应用。

Objective To investigate the clinical value of plasma asymmetric dimethylarginine detection in the diagnosis of bronchopulmonary dysplasia(BPD) with pulmonary arterial hypertension(PAH) in premature infants. Methods Thirty premature infants with BPD admitted to the Department of Obstetrics in the Affiliated Hospital of Qinghai University or Qinghai Women and Children Hospital from November 2015 to April 2017 were selected as the observation group and divided into two groups, namely the BPD+PAH group(n=12) and the BPD without PAH group(n=18), according to whether they were concurrent with PAH or not. Meanwhile, 32 premature infants without BPD hospitalized in the same period were randomly selected as the control group. The changes of ADMA levels at different days of age and the plasma ADMA, Arg, L-Arg/ADMA ratios at day 14 after birth of the three groups were compared. Results There was no statistically significant difference in the plasma ADMA value among the three groups at birth or day 7 after birth(P>0.05). There was statistically significant difference in the plasma ADMA value at day 14 after birth(P<0.05). There was statistically significant difference between the BPD +PAH group and the BPD without PAH group and between the BPD+PAH group and the control group, respectively(t=2.39, 2.62, P<0.05). There was no statistically significant difference between the BPD without PAH group and the control group(t=0.73, P>0.05). At day 14 after birth, in the BPD+PAH group, the plasma ADMA value was higher than that in the BPD without PAH group and that in the control group,respectively(P<0.05), the L-Arg/ADMA ratio was lower than that in the BPD without PAH group and that in the control group, respectively(P<0.01), and there was no significant difference in the L-Arg value between the three groups(P>0.05).Conclusion The plasma asymmetric dimethylarginine detection has important clinical value in the diagnosis of BPD with PAH in premature infants. Plasma ADMA, L-Arg/ADMA and BPD are closely related to the occurrence of BPD with PAH, which can serve as a predictive factor of disease and is worth promotion and application.