呼吸窘迫综合征早产儿血清NT-proBNP BMP-7及TGF-β1水平变化的临床研究

A Clinical Study on Changes of Serum NT-proBNP BMP-7 and TGF-β1 Levels in Premature Infants with Respiratory Distress Syndrome

目的:探讨呼吸窘迫综合征(RDS)早产儿血清氨基末端脑钠肽前体(NT-proBNP)、骨形态发生蛋白-7(BMP-7)及转化生长因子-β1(TGF-β1)水平变化的临床研究.方法:选择2016年4月到2018年4月在本院确诊的106例RDS早产儿,收集同期同年龄阶段非RDS早产儿53例为对照组.采用ELISA检测两组早产儿血清样品中NT-proBNP、BMP-7和TGF-β1表达水平;采用Pearson相关性分析NT-proBNP、BMP-7和TGF-β1与疾病严重程度之间的相关性,ROC曲线分析其对RDS的诊断价值.结果:与对照组相比,RDS患者血清中BMP-7、NT-proBNP和TGF-β1的表达水平显著升高(P<0.05);RDS早产儿血清NT-proBNP、BMP-7和TGF-β1均与RDS早产儿病情严重程度为正相关关系(r=0.402,P=0.000;r=0.311,P=0.018;r=0.313,P=0.015);NT-proBNP诊断RDS早产儿的截点值为3655.92ng/L,灵敏度为88.7%,特异度为3.8%,AUC为0.985;BMP-7诊断的截点值为44.85ng/L,灵敏度为63.2%,特异度为11.3%,AUC为0.829;TGF-β1诊断的截点值为36.73g/L,灵敏度为81.1%,特异度为17.0%,AUC为0.829;BMP-7联合TGF-β1诊断的灵敏度为89.6%,特异度为15.1%,AUC为0.934.结论:RDS患者血清NT-proBNP、BMP-7、TGF-β1水平显著升高,且其表达量与病情严重程度为正相关关系,有望作为其诊断和预后标识物.

Objective:To explore the clinical study on changes of serum Amino-terminal pro-brain natriuretic peptide(NT-proBNP),Bone morphogenetic protein-7(BMP-7)and Transforming growth factor-β1(TGF-β1)levels in premature infants with respiratory distress syndrome(RDS).Methods:A total of 106 premature infants with RDS diagnosed in the hospital from April 2016 to April 2018 were selected,and another 53 premature infants with non-RDS of the same age group at the same time period were collected as control group.The expression levels of NT-proBNP,BMP-7 and TGF-β1 in serum samples of premature infants were detected by ELISA in the two groups.The correlation between NT-proBNP,BMP-7 and TGF-β1 and disease severity was analyzed by Pearson correlation analysis.The ROC curve was used to analyze its diagnostic value for RDS.Results:Compared with control group,the expression levels of BMP-7,NT-proBNP and TGF-β1 in serum of RDS patients were significantly increased(P<0.05).Serum NT-proBNP,BMP-7 and TGF-β1 in premature infants with RDS were positively correlated with disease severity(r=0.402,P=0.000;r=0.311,P=0.018;r=0.313,P=0.015).The cut-off value,sensitivity,specificity and AUC of NT-proBNP in the diagnosis of premature infants with RDS were 3655.92 ng/L,88.7%,3.8%and 0.985.The cut-off value,sensitivity,specificity and AUC of BMP-7 diagnosis were 44.85 ng/L,63.2%,11.3%and 0.829.The cut-off value,sensitivity,specificity and AUC of TGF-β1 diagnosis were 36.73 g/L,81.1%,17.0%and 0.829.The sensitivity,specificity and AUC of BMP-7 combined with TGF-β1 were 89.6%,15.1%and 0.934.Conclusion:The levels of serum NT-proBNP,BMP-7 and TGF-β1 in RDS patients are significantly increased,and their expression levels are positively correlated with disease severity,and they are expected to be diagnostic and prognostic markers.