脐血CCSP、TGF-β1、IP-10水平与早产儿支气管肺发育不良的关系及预测价值

Relationship of levels of CCSP,TGF-β1,IP-10 in umbilical cord blood with bronchopulmonary dysplasia in premature infants and the predictive value

目的:探讨脐血Clara细胞分泌蛋白(Clara cell secretory protein,CCSP)、转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、干扰素诱导蛋白-10(Interferon induced protein-10,IP-10)水平与早产儿支气管肺发育不良(Bronchopulmonary dysplasia,BPD)的关系及预测价值。方法:选取2021年8月至2022年8月我院收治的80例早产儿作为研究对象,根据患儿出生后28 d是否发生BPD将患儿分为BPD组(n=31)和非BPD组(n=49),根据BPD严重程度将BPD患儿分为轻度、中度、重度三个亚组。比较两组入院时脐血CCSP、TGF-β1、IP-10水平,比较入院时轻度、中度、重度BPD患儿脐血CCSP、TGF-β1、IP-10水平,分析入院时脐血CCSP、TGF-β1、IP-10水平与BPD发生及BPD严重程度相关性,偏回归分析早产儿发生BPD的影响因素,受试者工作特征曲线(Receiver operating characteristic,ROC)分析入院时脐血CCSP、TGF-β1、IP-10水平对早产儿发生BPD的预测价值。结果:与非BPD组相比,入院时BPD组脐血CCSP水平较低,TGF-β1、IP-10水平较高(P<0.05);BPD患儿脐血CCSP水平比较:轻度BPD>中度BPD>重度BPD,脐血TGF-β1、IP-10水平比较:轻度BPD<中度BPD<重度BPD(P<0.05);入院时脐血CCSP水平与是否发生BPD及BPD严重程度均呈负相关,IP-10、TGF-β1水平与是否发生BPD及BPD严重程度均呈正相关(P<0.05);入院时TGF-β1(>8.37 ng·mL^(-1))、IP-10(>30.62 ng·mL^(-1))水平是早产儿发生BPD的危险因素,CCSP(>40.66 ng·mL^(-1))水平是早产儿发生BPD的保护因素;入院时脐血CCSP、TGF-β1、IP-10水平联合预测早产儿发生BPD的曲线下面积(Area Under Curve,AUC)为0.854。结论:脐血CCSP、TGF-β1、IP-10水平变化与早产儿BPD的发生具有显著相关性,为临床早期诊断、评估病情提供参考依据,以针对性制定治疗方案,降低病死率。

Objective:To investigate the relationship of levels of clara cell secretory protein(CCSP),transforming growth factor-β1(TGF-β1),interferon induced protein-10(IP-10)in umbilical cord blood with bronchopulmonary dysplasia(BPD)in premature infants and the predictive value.Methods:A total of 80 premature infants admitted to our hospital from August 2021 to August 2022 were selected as the research objects.The premature infants were divided into BPD group(n=31)and non BPD group(n=49)according to whether BPD occurred after 28 days of birth.According to the severity of BPD,the BPD infants were divided into mild,moderate and severe subgroups.The levels of CCSP,TGF-β1 and IP-10 in umbilical cord blood at admission were compared between BPD group and non BPD group;the levels of CCSP,TGF-β1 and IP-10 in umbilical cord blood at admission were compared among mild,moderate,and severe BPD;the relationship of levels of CCSP,TGF-β1 and IP-10 in umbilical cord blood at admission with the occurrence of BPD and severity of BPD were analyzed;influencing factors of BPD in premature infants were analyzed by partial regression analysis;the predictive value of the levels of CCSP,TGF-β1 and IP-10 in umbilical cord blood at admission for the occurrence of BPD in premature infants was analyzed by receiver operating characteristics(ROC).Results:Compared with the non BPD group,the level of CCSP in umbilical cord blood at admission was lower and the levels of TGF-β1 and IP-10 in umbilical cord blood at admission were higher in the BPD group(P<0.05);the level of CCSP in umbilical cord blood of BPD infants were mild BPD>moderate BPD>severe BPD,and the levels of TGF-β1 and IP-10 in umbilical cord blood were mild BPD<moderate BPD<severe BPD(P<0.05);the level of CCSP in umbilical cord blood at admission was negatively correlated with the occurrence of BPD and the severity of BPD,the levels of TGF-β1 and IP-10 at admission were positively correlated with the occurrence of BPD and the severity of BPD(P<0.05);the levels of TGF-β1(>8.37 ng·mL-1)and IP-10(>30.62 ng·mL-1)at admission were risk factors for the occurrence of BPD in premature infants,while the level of CCSP(>40.66 ng·mL-1)was protective factor for the occurrence of BPD in premature infants;the Area Under Curve(AUC)of the levels of CCSP,TGF-β1 and IP-10 in umbilical cord blood at admission combined prediction for the occurrence of BPD in premature infants was 0.854.Conclusion:The changes of levels of CCSP,TGF-β1 and IP-10 in umbilical cord blood are significantly correlated with the occurrence of BPD in premature infants,which can provide a reference basis for early clinical diagnosis and evaluation of BPD infants in order to develop targeted treatment plans and reduce mortality.