血清IGF-1、25-(OH)D水平联合检测对早产儿支气管肺发育不良的相关性研究

Correlation study of serum IGF-1 and 25(OH)D combined detection on bronchopulmonary dysplasia in premature infants

目的:分析血清胰岛素样生长因子-1(IGF-1)、25-羟维生素D[25-(OH)D]水平联合检测对早产儿支气管肺发育不良(BPD)的相关性。方法:回顾性收集漯河市中心医院2021年1月至2022年12月收治的早产儿为研究对象(n=115)。根据患儿是否发生支气管肺发育不良,分为BPD组、非BPD组;根据患儿吸氧情况将BPD患儿分为轻、中、重度患者。对比两组临床一般资料及入院时血清IGF-1、25-(OH)D水平;Logistic回归分析影响早产儿BPD发生的影响因素;对比不同病情程度患者入院时血清各指标水平;分析血清各指标水平与早产儿BPD严重程度的相关性。ROC分析血清各指标联合检测对早产儿发生BPD的预测价值。结果:两组新生儿(Apgar)评分、氧气浓度(出生后首次吸氧浓度)、吸氧时间均存在差异(P<0.05);出生后BPD组血清IGF-1、25-(OH)D水平低于非BPD组(P<0.05);Logistic回归分析显示,出生后吸氧时间、氧气浓度、IGF-1、25-(OH)D为早产儿发生BPD的危险因素(P<0.05);血清IGF-1、25-(OH)D随患者病情程度的加重显著升高,轻度>中度>重度(P<0.05);出生后BPD患者血清IGF-1、25-(OH)D与病情程度均呈正相关(P<0.05);ROC分析出生后血清IGF-1、25-(OH)D水平联合预测早产儿发生BPD的AUC为0.926。结论:血清IGF-1、25-(OH)D与BPD患儿密切相关,临床早期检测其水平可作为早期预测BPD发生及评估其严重程度的有效指标。

Objective:To analyze the correlation between serum insulin-like growth factor-1(IGF-1)and 25-hydroxyvitamin D[25(OH)D]levels in premature infants with bronchopulmonary dysplasia(BPD).Methods:Preterm infants admitted to Luohe Central Hospital from January 2021 to December 2022 were selected as study objects(n=115).The children were divided into BPD group and non-BPD group according to whether bronchopulmonary dysplasia occurred.Children with BPD were divided into mild,moderate and severe patients according to their oxygen intake.The general clinical data and serum IGF-1 and 25(OH)D levels at admission were compared between the two groups.Logistic regression analysis was conducted to analyze the influencing factors of BPD in preterm infants.The levels of serum indexes of patients with different disease degrees were compared at admission.To analyze the correlation between the level of serum indexes and the severity of BPD in preterm infants.Predictive value of ROC analysis combined detection of serum indexes for BPD in premature infants.Results:There were differences in Apgar score,Oxygen concentration(first oxygen concentration after birth)and oxygen inhalation time between the two groups(P<0.05).The levels of serum IGF-1 and 25(OH)D in BPD group after birth were lower than those in non-BPD group(P<0.05).Logistic regression analysis showed that postnatal oxygen intake time,oxygen concentration,IGF-1 and 25(OH)D were risk factors for BPD in preterm infants(P<0.05).Serum IGF-1 and 25(OH)D were significantly increased with the severity of the disease,mild>moderate>severe(P<0.05);Serum IGF-1 and 25(OH)D were positively correlated with the severity of BPD after birth(P<0.05).ROC analysis of postnatal serum IGF-1 and 25(OH)D levels combined to predict the AUC of BPD in preterm infants was 0.926.Conclusion:Serum IGF-1 and 25(OH)D are closely related to children with BPD.Early detection of IGF-1 and 25(OH)D can be used as an effective index to predict the occurrence and severity of BPD.