支气管肺发育不良早产儿血浆血管紧张素Ⅱ水平变化及临床价值

Level changes and clinical value of plasma angiotensinⅡin premature infants with bronchopulmonary dysplasia

目的探讨支气管肺发育不良(BPD)早产儿血浆中血管紧张素Ⅱ(AngⅡ)的水平变化及临床价值。方法选取2020年3月至2021年12月扬州大学附属苏北人民医院收治的胎龄<32周的早产儿60例为研究对象,其中BPD早产儿32例(BPD组)、非BPD早产儿28例(非BPD组);BPD组早产儿又根据BPD严重程度分为轻度组(15例)、中度组(9例)、重度组(8例)。分别检测研究对象出生后24 h、7 d、14 d时血浆AngⅡ水平。采用受试者工作特征(ROC)曲线分析血浆AngⅡ检测对早产儿BPD的诊断价值。采用Spearman相关分析血浆AngⅡ水平与BPD严重程度的相关性。结果出生后7、14 d BPD组血浆AngⅡ水平均高于非BPD组,差异有统计学意义(P<0.05)。BPD组出生后24 h、7 d、14 d的血浆AngⅡ水平逐渐升高,差异有统计学意义(P<0.05)。出生后7、14 d,随着BPD严重程度增加,血浆AngⅡ水平逐渐升高,差异有统计学意义(P<0.05)。BPD早产儿出生后7 d血浆AngⅡ水平与BPD严重程度呈正相关(r=0.454,P<0.05)。出生后24 h、7 d、14 d的血浆AngⅡ检测诊断早产儿BPD的曲线下面积(AUC)分别为0.410、0.721、0.876,特异度分别为0.964、0.571、0.714,灵敏度分别为0.156、0.844、0.969。结论血浆AngⅡ水平与早产儿BPD的发生、发展密切相关。动态监测血浆AngⅡ水平变化可为早期诊断早产儿BPD及评估其严重程度提供参考。

Objective To investigate the level changes and clinical value of plasma angiotensinⅡ(AngⅡ)in premature infants with bronchopulmonary dysplasia(BPD).Methods A total of 60 premature infants with a gestational age less than 32 weeks admitted to the China Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from March 2020 to December 2021 were selected as the research objects.Among them,there were 32 BPD premature infants(BPD group)and 28 non-BPD premature infants(non-BPD group).The premature infants in the BPD group were further divided into mild group(15 cases),moderate group(9 cases),and severe group(8 cases)according to the severity of BPD.Plasma AngⅡlevels of the research objects were detected at 24 h,7 d and 14 d after birth.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of plasma AngⅡdetection for BPD in premature infants.Spearman correlation was used to analyze the correlation between plasma AngⅡlevel and BPD severity.Results The plasma AngⅡlevels in the BPD group at 7 d and 14 d after birth were higher than those in the non-BPD group,and the differences were statistically significant(P<0.05).The plasma AngⅡlevels in the BPD group increased gradually at 24 h,7 d and 14 d after birth,and the differences were statistically significant(P<0.05).At 7 d and 14 d after birth,with the increase of the severity of BPD,the levels of plasma AngⅡgradually increased,and the differences were statistically significant(P<0.05).Plasma AngⅡlevel of BPD premature infants at 7 d after birth was positively correlated with the severity of BPD(r=0.454,P<0.05).The area under the curve(AUC)of plasma AngⅡdetection at 24 h,7 d and 14 d after birth for the diagnosis of BPD in premature infants was 0.410,0.721,0.876 respectively,the specificity was 0.964,0.571,0.714 respectively,and the sensitivity was 0.156,0.844,0.969 respectively.Conclusion Plasma AngⅡlevel is closely related to the occurrence and development of BPD in premature infants.Dynamic monitoring of plasma AngⅡlevel can provide a reference for early diagnosis of BPD in premature infants and assessment of its severity.