血浆TGF-β1、BMP-7水平对早产儿支气管肺发育不良的预测价值

Predictive value of plasma TGF-β1 and BMP-7 levels in premature infants with bronchopulmonary dysplasia

目的探讨血浆转化生长因子-β1(TGF-β1)、骨形成蛋白-7(BMP-7)水平对早产儿支气管肺发育不良(BPD)的预测价值。方法选取早产儿500例,根据是否发生BPD分为BPD组185例和非BPD组(NBPD组)315例。比较两组临床特点及血浆TGF-β1、BMP-7水平差异,探讨早产儿BPD的危险因素,分析TGF-β1、BMP-7对早产儿BPD的预测价值。结果BPD组机械通气时间、吸氧浓度、吸氧时间、呼吸窘迫综合征比例、顺产比例高于NBPD组,出生体质量、Apgar评分(1 min、5 min)低于NBPD组(P均<0.05)。BPD组出生时和出生后(第7天、14天、21天)的血浆TGF-β1、BMP-7水平均高于同时间点NBPD组(P均<0.05)。Logistic多因素回归分析显示顺产、吸氧时间、机械通气时间、TGF-β1、BMP-7均是早产儿BPD的危险因素(P均<0.05)。早产儿出生时脐血TGF-β1、BMP-7预测BPD的ROC曲线下面积(AUC)分别为0.757、0.808,TGF-β1联合BMP-7预测BPD的AUC为0.848,高于TGF-β1、BMP-7任一单项指标(P均<0.05)。结论血浆TGF-β1、BMP-7是早产儿并发BPD的独立危险因素,二者联合检测可提高对早产儿BPD的预测效能。

Objective To analyze the predictive value of plasma transforming growth factor-β1(TGF-β1)and bone morphogenetic protein-7(BMP-7)levels for bronchopulmonary dysplasia(BPD)in premature infants.Methods A total of 500 cases of premature infants were selected as the study objects.According to the occurrence of BPD,they were divided into the BPD group(185 cases)and the non-BPD group(NBPD group,315 cases).The difference of TGF-β1,BMP-7 and general clinical data between the two groups were compared,and the predictive value of TGF-β1 and BMP-7 for premature infants with BPD was analyzed.Results The mechanical ventilation time,oxygen absorption concentration,oxygen absorption time,the proportion of respiratory distress syndrome and the rate of spontaneous delivery in children in the BPD group were significantly higher than those in the NBPD group,while the birth weight and Apgar score(1 min,5 min)were significantly lower than those in the NBPD group(all P<0.05).The plasma levels of TGF-β1 and BMP-7 in the BPD group at birth and after birth(day 7,day 14,day 21)were higher than those in the NBPD group at the same time point(all P<0.05).Logistic multivariate regression analysis showed that spontaneous delivery,oxygen absorption time,mechanical ventilation time,TGF-β1 and BMP-7 were all risk factors for BPD premature infants(all P<0.05).The area under ROC curve(AUC)of TGF-β1 and BMP-7 plasma at birth were 0.757 and 0.808,respectively,and the AUC of TGF-β1 combined with BMP-7 was 0.848,which was higher than any single indicator of TGF-β1 and BMP-7(all P<0.05).Conclusion Plasma TGF-β1 and BMP-7 are independent risk factors for BPD in premature infants,and combined detection of them can improve the predictive efficacy.