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[尿半胱氨酰白三烯E4水平评估在早产儿支气管肺发育不良诊断中的应用]

[Evaluation of the level of urinary cysteinyl leukotriene E4 in diagnosis of bronchopulmonary dysplasia in premature infants].

作者信息

Jin R, Lu H Y, Luo Y Y, Xu Y X, Hu Y H, Chen X Q

机构信息

Department of Pediatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.

出版信息

Zhonghua Er Ke Za Zhi. 2016 Sep;54(9):703-7. doi: 10.3760/cma.j.issn.0578-1310.2016.09.014.

Abstract

OBJECTIVE

To explore the correlation of urinary cysteinyl leukotriene E4 (CysLTE4) and diagnosis of bronchopulmonary dysplasia (BPD) in premature infants.

METHOD

One hundred and fifty-eight newborn infants were consecutively admitted to the neonatal intensive care units of First Affiliated Hospital of Nanjing Medical University from November 2014 to October 2015.The infants were divided into 3 groups according to the diagnosis on discharge.Sixty-one term infants were classified as having no pulmonary diseases, 52 premature infants were classified as without BPD, and 45 premature infants with BPD were diagnosed at 28 d after birth.Urinary CysLTE4 levels of newborns within 3 days after birth were measured in a blinded way by enzyme- linked immunosorbent assay and were compared among 3 groups, and were evaluated for the diagnostic value and the correlation of gestational age and birth weight.Statistical analysis was performed using correlation analysis, one-way analysis of variance and χ(2) test etc.

RESULT

In infants with BPD, the mean urinary CysLTE4 level was (191.0±29.3) ng/L which significantly higher than the premature group without BPD ((164.1±22.7) ng/L) and term infant group ((151.6±41.9) ng/L, F=18.70, P<0.05). Urinary CysLTE4 level within 3 days of life in newborn inversely correlated with gestational age and birth weight (Pearson=-0.33, -0.38, P<0.01). The area under the curve was 0.78, 95%CI: 0.70-0.86, P<0.01, when cutoff was 187.7 ng/L, with Youden index 0.59, sensitivity 77.8% and specificity 81.4%, respectively.

CONCLUSION

Urinary CysLTE4 level is up-regulated in BPD infants within early days of life which may be a useful biomarker of early diagnoses of BPD.

摘要

目的

探讨尿半胱氨酰白三烯E4(CysLTE4)与早产儿支气管肺发育不良(BPD)诊断的相关性。

方法

选取2014年11月至2015年10月期间连续入住南京医科大学第一附属医院新生儿重症监护病房的158例新生儿。根据出院诊断将患儿分为3组。61例足月儿被归类为无肺部疾病,52例早产儿被归类为无BPD,45例早产儿在出生后28天被诊断为BPD。采用酶联免疫吸附测定法对出生后3天内新生儿的尿CysLTE4水平进行盲法检测,并在3组之间进行比较,同时评估其诊断价值以及与胎龄和出生体重的相关性。采用相关分析、单因素方差分析和χ²检验等进行统计学分析。

结果

BPD患儿的尿CysLTE4平均水平为(191.0±29.3)ng/L,显著高于无BPD的早产组((164.1±22.7)ng/L)和足月儿组((151.6±41.9)ng/L,F=18.70,P<0.05)。新生儿出生后3天内的尿CysLTE4水平与胎龄和出生体重呈负相关(Pearson=-0.33,-0.38,P<0.01)。当截断值为187.7 ng/L时,曲线下面积为0.78,95%CI:0.70-0.86,P<0.01,约登指数为0.59,敏感性和特异性分别为77.8%和81.4%。

结论

BPD患儿出生早期尿CysLTE4水平上调,可能是BPD早期诊断的有用生物标志物。

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