支气管肺发育不良早产儿血清YKL-40和HMGB1水平的变化

Changes in serum human cartilage glycoprotein-39 and high-mobility group box 1 in preterm infants with bronchopulmonary dysplasia

目的探究早产儿生后外周血人软骨糖蛋白-39(YKL-40)、高迁移率族蛋白1(HMGB1)水平动态变化与支气管肺发育不良(BPD)的关系。方法前瞻性选择2017年7月至2019年8月新生儿重症监护室收治的出生胎龄≥28周且<32周、出生体重<1500 g的早产儿,根据诊断分为BPD组(n=35)和非BPD组(n=51)。通过酶联免疫吸附法检测早产儿生后第3、7、14天血清YKL-40和HMGB1浓度并进行比较。结果BPD组第3、7、14天血清YKL-40浓度均低于非BPD组(P<0.001),HMGB1浓度均高于非BPD组(P<0.001)。两组第7、14天血清YKL-40及HMGB1浓度均高于第3天(P<0.017)。BPD组第14天HMGB1浓度高于第7天(P<0.017),第7、14天YKL-40浓度差异无统计学意义(P>0.017)。非BPD组第14天YKL-40浓度高于第7天(P<0.017),第7、14天HMGB1浓度差异无统计学意义(P>0.017)。结论BPD及非BPD早产儿生后第3、7、14天外周血中YKL-40及HMGB1水平存在差异,两者可能与BPD的形成相关。

Objective To study the association of the dynamic changes of peripheral blood human cartilage glycoprotein-39(YKL-40)and high-mobility group box 1(HMGB1)with bronchopulmonary dysplasia(BPD)in preterm infants.Methods Preterm infants,with a gestational age of 28-32 weeks and a birth weight of<1500 g,who were admitted to the neonatal intensive care unit from July 2017 to August 2019 were prospectively selected and divided into a BPD group with 35 infants and a non-BPD group with 51 infants.ELISA was used to measure the serum concentrations of YKL-40 and HMGB1 in preterm infants on days 3,7,and 14 after birth.Results The BPD group had a significantly lower serum YKL-40 concentration and a significantly higher serum HMGB1 concentration than the nonBPD group on days 3,7,and 14(P<0.001).The serum concentrations of YKL-40 and HMGB1 on days 7 and 14 were significantly higher than those on day 3 in both groups(P<0.017).In the BPD group,HMGB1 concentration on day 14 was significantly higher than that on day 7(P<0.017),while there was no significant change in YKL-40 concentration from day 7 to day 14(P>0.017).In the non-BPD group,YKL-40 concentration on day 14 was significantly higher than that on day 7(P<0.017),while there was no significant change in HMGB1 concentration from day 7 to day 14(P>0.017).Conclusions There are significant differences in the levels of YKL-40 and HMGB1 in peripheral blood between the preterm infants with BPD and those without BPD on days 3,7,and 14 after birth,suggesting that YKL-40 and HMGB1 might be associated with the development of BPD.