N端脑钠肽前体及B型脑钠肽在早产儿动脉导管未闭预测中的研究

来源 :中国医师进修杂志 | 被引量 : 0次 | 上传用户:mj3140
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目的:探讨生后早期N端脑钠肽前体(NT- pro BNP)及B型脑钠肽(BNP)在早产儿症状性动脉导管未闭(sPDA)中的预测价值。方法:选取2017年7月1日至2019年1月1日入住大连市妇女儿童医疗中心的早产儿60例,胎龄26~32周,出生体质量<1 500 g。生后第3天依据超声心动图,分为动脉导管未闭(PDA)组(40例)、对照组(20例);PDA组分为sPDA组(20例)和无症状(asPDA)组(20例);sPDA组分为治疗组(10例)与非治疗组(10例);asPDA组分为自闭组(10例)和未自闭组(10例)。分别于生后第3、7天测血NT-pro BNP及BNP。结果:sPDA组、asPDA组与对照组生后第3、7天NT-pro BNP水平比较差异有统计学意义(n P<0.05);生后第7天治疗组NT-pro BNP[4 082(111~7 566)ng/L]与非治疗组[9 643(2 362~25 000)ng/L]比较差异有统计学意义(n P<0.05),自闭组[603(27~1 698)ng/L]与未自闭组[4 595(896~9 873)ng/L]比较差异有统计学意义(n P<0.05)。生后第3天NT-pro BNP与动脉导管(DA)直径、左心房/主动脉根部内径比值、DA直径与左肺动脉内径比值呈正相关(n r=0.358~0.455,n P<0.05);NT-pro BNP受试者工作特征曲线下面积为0.783。n 结论:早产儿生后第3天血NT-pro BNP可作为预测sPDA的参考指标。“,”Objective:To explore the predictive value of N-terminal-pro-B-type brain natriaretic peptide (NT-pro BNP) and B-type brain natriaretic peptide (BNP) of symptomatic patent ductus arteriosus (sPDA) in premature infants.Methods:Sixty premature infants were recruited. The gestational age was 26-32 weeks and the birth weight was less than 1 500 g. According to the echocardiography measured on the 3rd day, the infants were divided into PDA group (40 cases) and control group (20 cases). PDA group was divided into sPDA group (20 cases) and asPDA group (20 cases). The sPDA group was divided into treatment group (10 cases) and non-treatment group (10 cases). The asPDA group was further divided into self-closed group (10 cases) and non- self-closed group (10 cases). NT-pro BNP and BNP were examined on the 3rd and 7th day.Results:The level of NT-pro BNP among sPDA group, asPDA group and control group had significant difference on the 3rd and 7th day (n P<0.05). On the 7th day, the level of NT-pro BNP between treatment group and non-treatment group had significant difference [4 082(111 - 7 566) ng/L vs. 9 643 (2 362 - 25 000) ng/L,n P<0.05] between self-closed group and non- self-closed group [603 (27 - 1 698) ng/L vs. 4 595 (896 - 9 873) ng/L,n P<0.05]. The level of NT-pro BNP on the 3rd day was positively correlated with of ductus arteriosus diameter, ratio of left atrium diameter and aortic root diameter, ratio of ductus arteriosus diameter and left pulmonary artery diameter (n r=0.358 - 0.455, n P<0.05). The area under the curve drawn by NT-pro BNP on the 3rd day was 0.783.n Conclusions:The level of NT-pro BNP on the 3rd day can be used as a predictor of sPDA.
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