| 车玲,彭华保,朱文军,黄芳,史文元,曾群.动脉导管未闭早产儿血N端脑钠肽前体水平变化及临床意义.[J].中南医学科学杂志.,2016,(4):447-452. |
| 动脉导管未闭早产儿血N端脑钠肽前体水平变化及临床意义 |
| Change in Plasma NT-proBNP Level in Preterm Infants withPatent Ductus Arteriosus and its Clinical Significance |
| 投稿时间：2016-01-19 修订日期：2016-05-03 |
| DOI： |
| 中文关键词: 动脉导管未闭 NT-proBNP 早产儿 血浆 |
| 英文关键词:patent ductus arteriosus N-terminal pro-B-type natriuretic peptide preterm infant plasma |
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| 中文摘要: |
| 目的 探讨动脉导管未闭(PDA)早产儿血浆N端脑钠肽前体(NT-proBNP)的变化及临床意义。方法选取合并PDA早产儿107例,分PDA组39例与对照组(非PDA组)68例；PDA组根据有无超声血流动力学显著性改变及临床表现分为症状性PDA(sPDA)组20例和无症状性PDA(asPDA)组19例；sPDA组根据是否服用布洛芬分为治疗组13例与非治疗组7例；PDA早产儿根据是否合并支气管肺发育不良(BPD)分BPD组19例与非BPD组15例。所有对象分别于生后第1、4、7天进行NT-proBNP检测,采血后30 min内行超声心动图检查。结果sPDA组生后第4、7天血浆NT-proBNP水平高于同期asPDA组和对照组(P＜0.05)；asPDA组生后第4天血浆NT-proBNP水平高于对照组(P＜0.05)。sPDA组生后第4天血浆NT-proBNP水平高于第1、7天(P＜0.05),asPDA组生后第1、4天血浆NT-proBNP水平高于第7天(P＜0.05)。治疗组生后第7天血浆NT-proBNP水平较第4天显著下降(P＜0.05),非治疗组生后第7天血浆NT-proBNP水平与第4天比较,差异无显著性(P＞0.05)。sPDA组BPD发生率(76.47%)高于asPDA组(35.29%)(P＜0.05)。BPD组生后第4、7天血浆NT-proBNP水平高于非BPD组,其中第4天比较,差异有显著性(P＜0.05),第7天比较,差异无显著性(P＞0.05)。结论PDA尤其是sPDA早产儿血浆NT-proBNP水平明显增高,导管关闭或分流量减小其水平下降,早期血浆NT-proBNP水平越高,发生BPD的几率越大。动态监测血浆NT-proBNP水平对sPDA诊断、疗效判断及预后评估有参考价值。 |
| 英文摘要: |
| Objective To explore the change and clinical significance of plasma NT-proBNP in preterm infants with patent ductus arteriosus (PDA).MethodsA total of 107 preterm infants with PDA were recruited and divided into the PDA group (n=39) and the control group (n=68).According to whether there were clinical symptoms and significant hemodynamics changes by using ultrasonography,infants in the PDA group were classified into the sPDA group (n=20) and the asPDA group (n=19).The sPDA group was divided into treatment group and non-treatment group in the light of whether ibuprofen was taken.According to whether there was complication of BPD,infants with PDA were divided into the BPD group and the non-BPD group.Plasma NT-proBNP concentrations were measured on day 1,4 and 7 of life and echocardiography examination was performed within 30 minutes after collection of blood sampling.ResultsPlasma concentration of NT-proBNP of sPDA group was higher than those of the asPDA group and control group on the fourth and seventh day after birth (P＜0.05);infants in the asPDA group had higher plasma NT-proBNP levels than those in control group on the fourth day of life (P＜0.05).In the sPDA group,plasma level of NT-proBNP on the fourth day after birth was obviously higher than that on the first and seventh day after birth (P＜0.05);plasma NT-proBNP concentrations on the first and fourth day after birth of infants in the asPDA group were higher than those on the seventh day after birth (P＜0.05).Plasma NT-proBNP concentrations on day 7 after birth of infants in the treatment group were significantly decreased compared to those on the fourth day after birth (P＜0.05);there was no significant difference of the plasma concentration of NT-proBNP in the non-treatment group on the fourth and seventh day after birth (P＞0.05).The prevalence of BPD in the sPDA group was 76.47%,which was higher than that in the asPDA group (35.29%),the difference was statistically significant (P＜0.05).Infants in the BPD group had higher plasma NT-proBNP concentrations than those in the non-BPD group on the fourth and seventh day after birth;there was significant difference between the two groups regarding plasma NT-proBNP concentrations on the fourth day after birth (P＜0.05),but no statistical difference was observed between the two groups on the seventh day (P＞0.05).ConclusionThe plasma NT-proBNP concentrations were higher in preterm infants with PDA,and more marked elevation in sPDA infants,which decreases obviously with closure of DA and decrease of shunt volume;the higher early-stage plasma NT-proBNP level of preterm infants with PDA was,the more likely it was to develop BPD.Serial measurements of NT-proBNP may be of value for diagnosis of PDA,monitoring of curative effect and assessment of prognosis. |
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