血清SP-A水平联合肺部超声评分对新生儿呼吸窘迫综合征的评估价值

Evaluation of the Severity and Prognosis of Neonatal Respiratory Distress Syndrome with Serum SP-A Level and Pulmonary Ultrasound Score

目的探究血清肺表面活性蛋白(SP-A)水平联合肺部超声评分对新生儿呼吸窘迫综合征(NRDS)严重程度及预后的评估价值。方法选择2021年8月至2022年3月赣州市妇幼保健院收治的90例NRDS新生儿作为NRDS组,并选择同期健康新生儿45例作为对照组。比较两组血清SP-A水平及肺部超声评分;比较不同病情严重程度NRDS新生儿血清SP-A水平及肺部超声评分;分析影响NRDS新生儿预后不良的风险因素及血清SP-A水平联合肺超声评分在判断NRDS新生儿病情严重程度及预后中的价值。结果NRDS组血清SP-A水平高于对照组,肺部超声评分低于对照组(P<0.05)。中、重度组血清SP-A水平高于轻度组,肺超声评分低于轻度组(P<0.05);重度组血清SP-A水平高于中度组,肺超声评分低于中度组(P<0.05)。经logistic回归分析显示,母体有妊娠期糖尿病、血清SP-A水平较高为NRDS新生儿预后不良的危险因素(OR>1,P<0.05);胎龄较高、肺超声评分较高为NRDS新生儿预后不良的保护因素(OR<1,P<0.05)。绘制ROC曲线,结果显示,血清SP-A水平联合肺超声评分评估NRDS新生儿病情严重程度及预后的曲线下面积(AUC)为0.913、0.896,评估价值较单一检测高。结论血清SP-A水平、肺部超声评分与NRDS新生儿病情严重程度及预后密切相关,联合检测可提升NRDS新生儿病情程度及预后的评估价值。

Objective To explore the value of serum pulmonary surfactant protein(SP-A)level combined with pulmonary ultrasound score in evaluating the severity and prognosis of neonatal respiratory distress syndrome(NRDS).Methods 90 NRDS neonates admitted to Ganzhou Maternal and Child Health Hospital from August 2021 to March 2022 were selected as the NRDS group,and 45 healthy neonates in the same period were selected as the control group.The serum SP-A level and pulmonary ultrasound score were compared between the two groups;to compare the serum SP-A level and pulmonary ultrasound score of neonates with NRDS of different severity;to analyze the risk factors affecting the poor prognosis of NRDS neonates and the value of serum SP-A level combined with pulmonary ultrasound score in judging the severity and prognosis of NRDS neonates.Results The serum SP-A level in NRDS group was higher than that in control group,and the pulmonary ultrasound score was lower than that in control group(P<0.05).The serum SP-A level in moderate and severe group was higher than that in mild group,and the pulmonary ultrasound score was lower than that in mild group(P<0.05);serum SP-A level in severe group was higher than that in moderate group,and pulmonary ultrasound score was lower than that in moderate group(P<0.05).Logistic regression analysis showed that maternal diabetes and high serum SP-A level were risk factors for poor prognosis of NRDS newborns(OR>1,P<0.05);higher fetal age and higher pulmonary ultrasound score were protective factors for poor prognosis of NRDS neonates(OR<1,P<0.05).The ROC curve was drawn,and the results showed that the area under the curve(AUC)of serum SP-A level combined with pulmonary ultrasound score in evaluating the severity and prognosis of NRDS neonates were 0.913 and 0.896,which were more valuable than single detection.Conclusion Serum SP-A level and lung ultrasound score are closely related to the severity and prognosis of NRDS neonates.Combined detection can improve the evaluation value of the severity and prognosis of NRDS neonates.