极低出生体重早产儿血清25(OH)D3及血浆sNGAL的表达与支气管肺发育不良的关系研究

Relationship between the Expression of Serum 25(OH)D3 and Plasma sNGAL and Bronchopulmonary Dysplasia in Very Low Birth Weight Preterm Infants

目的研究极低出生体重早产儿血清25-羟维生素D3[25(OH)D3]及血浆中性粒细胞明胶酶相关载脂蛋白(sNGAL)的表达,并分析2项指标与患儿支气管肺发育不良的关系。方法选取某院新生儿科2019年11月1日-2020年11月30日的40例出生体重<1500g极低出生体重早产儿纳入研究组;选取新生儿科同期的40例出生体重为1500~2500g低出生体重早产儿纳入对照组;同时选取医院产科同期出生的40例出生体重为2500~4000g正常新生儿纳入正常组。采集3组新生儿出生后第1天的静脉血作为样本,分别运用化学发光免疫分析法与酶联免疫吸附法对其进行血清25(OH)D3及血浆sNGAL检测,对比3组的检测结果。另外对研究组早产儿进行支气管肺发育不良评估,统计支气管肺发育不良发生率,并将其纳入A组,将非支气管肺发育不良早产儿纳入B组,对比2组的血清25(OH)D3及血浆sNGAL检测结果,运用多因素Logistic回归分析法分析血清25(OH)D3及血浆sNGAL与支气管肺发育不良的关系。结果研究组新生儿的血清25(OH)D3检测值低于对照组与正常组,血浆sNGAL检测值高于对照组与正常组,均P<0.05;对照组的新生儿的血清25(OH)D3检测值低于正常组,血浆sNGAL检测值高于正常组,均P<0.05。研究组40例早产儿中,发生支气管肺发育不良13例,发生率为32.50%;A组与B组的血清25(OH)D3及血浆sNGAL检测结果显示A组早产儿的血清25(OH)D3检测值低于B组,血浆sNGAL检测值高于B组,均P<0.05。多因素Logistic回归分析结果显示血清25(OH)D3(≤10ng/mL)、血浆sNGAL(≥100μg/L)是发生支气管肺发育不良的独立危险因素。结论极低出生体重早产儿血清25(OH)D3呈低表达状态,血浆sNGAL呈高表达状态;极低出生体重早产儿血清25(OH)D3及血浆sNGAL与支气管肺发育不良之间存在明显的相关性,血清25(OH)D3≤10ng/mL、血浆sNGAL≥100μg/L是发生支气管肺发育不良的独立危险因素。

Objectives To study the expression of serum 25 hydroxyvitamin D3[25(OH)D3]and plasma neutrophil gelatinase associated apolipoprotein(sNGAL)in very low birth weight preterm infants,and analyze the relationship between the two indexes and bronchopulmonary dysplasia.Methods 40 cases of very low birth weight premature infants(birth weight<1500 g)from November 1st,2019 to November 30th,2020 in the department of neonatology of our hospital were selected as the research objects and included into the study group;40 cases of low birth weight premature infants(birth weight of 1500-2500 g)at the same period in the neonatal department of our hospital were selected as the control group;at the same time,40 cases of obstetric delivery in our hospital at the same time were selected.Normal newborns(birth weight of 2500-4000 g)were included in the normal group.The venous blood of three groups of newborns on the first day after birth was collected as samples,serum 25(OH)D3 and plasma sNGAL were detected by chemiluminescent immunoassay(CLIA)and enzyme-linked immunosorbent assay(ELISA).In addition,the study group was evaluated for bronchopulmonary dysplasia,and the incidence of bronchopulmonary dysplasia was counted and included in group A.The preterm infants without bronchopulmonary dysplasia were included in group B.The serum 25(OH)D3 and plasma sNGAL were compared between the two groups.The relationship between serum 25(OH)D3 and plasma s NGAL and bronchopulmonary dysplasia was analyzed by multivariate logistic regression analysis.Results The serum 25(OH)D3 detection value of the study group was lower than that of the control group and the normal group,and the plasma sNGAL detection value was higher than that of the control group and the normal group,all P<0.05;the serum 25(OH)D3 detection value of the control group was lower than that of the normal group,and the plasma sNGAL detection value was higher than the normal group,all P<0.05.Among 40 premature infants in the study group,13 cases had bronchopulmonary dysplasia,the incidence rate was 32.50%;the detection results of serum 25(OH)D3 and plasma sNGAL in group A and group B showed that the detection value of serum 25(OH)D3 in group A was lower than that in group B,and the detection value of plasma sNGAL was higher than that in group B,all P<0.05.Multivariate logistic regression analysis showed that serum 25(OH)D3≤10 ng/ml and plasma sNGAL≥100μg/L were independent risk factors for bronchopulmonary dysplasia.Conclusions The expression of serum 25(OH)D3 was low and plasma sNGAL was high in VLBW preterm infants;there was significant correlation between serum 25(OH)D3 and plasma sNGAL and bronchopulmonary dysplasia.Serum 25(OH)D3≤10 ng/ml and plasma sNGAL≥100μg/L were independent risk factors for bronchopulmonary dysplasia.