| 曾雅丽,黄鹏,刁诗光,等.早期预测早产儿动脉导管未闭的临床指标研究[J].安徽医药,2019,23(8):1550-1554. |
| 早期预测早产儿动脉导管未闭的临床指标研究 |
| Study on clinical indicators for early prediction of patent ductus arteriosus in premature infants |
| 投稿时间：2018-12-05 |
| DOI： |
| 中文关键词: 动脉导管未闭 利钠肽,脑 肌钙蛋白T 受体,降钙素 磷酸丙酮酸水合酶 血小板计数 布洛芬 早期诊断 婴儿,早产 |
| 英文关键词: Ductus arteriosus,patent Natriuretic peptide,brain Troponin T Receptors,calcitonin Phosphopyruvate hydratase Platelet count Ibuprofen Early diagnosis Infant,premature |
| 基金项目: |
| 作者 | 单位 | | 曾雅丽 | 汕头大学医学院附属粤北人民医院,新生儿科,广东 韶关 512026 | | 黄鹏 | 汕头大学医学院附属粤北人民医院儿科,广东 韶关 512026 | | 刁诗光 | 汕头大学医学院附属粤北人民医院,新生儿科,广东 韶关 512026 | | 刘晓燕 | 汕头大学医学院附属粤北人民医院,新生儿科,广东 韶关 512026 | | 邱建武 | 汕头大学医学院附属粤北人民医院,新生儿科,广东 韶关 512026 | | 陈亚丽 | 汕头大学医学院附属粤北人民医院,新生儿科,广东 韶关 512026 |
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| 中文摘要: |
| 目的 探讨可早期预测早产儿动脉导管未闭(patent ductus arteriosus,PDA)的临床指标。方法 采用前瞻性观察研究,选择2017年1—12月生后24 h内入住汕头大学医学院附属粤北人民医院治疗的61例早产儿(胎龄<37周)为研究对象,超声心动图检查存在早产儿症状性PDA(significant PDA,sPDA)的26例为观察组,无sPDA 的35例为对照组,其中观察组给予布洛芬混悬液口服治疗后,第1个疗程结束后复查超声心动图检查,仍存在sPDA的为持续开放组,无sPDA的为关闭组。生后检测血浆B型脑钠肽(BNP)、肌钙蛋白T(cTnT)、降钙素原(PCT)、神经元特异性烯醇化酶(NSE)、血小板计数(PLT),比较观察组与对照组、持续开放组与关闭组各临床指标间的差异,通过ROC曲线制定药物干预指征。结果 观察组血浆BNP、cTnT、NSE水平分别为(3 483.00±1 560.11)pg/mL、(89.17±35.67)pg/mL、(100.06±84.81)ng/mL,均高于对照组(2 380.65±1 105.15)pg/mL、(62.62±17.89)pg/mL、(60.69±35.17)ng/mL,差异有统计学意义(P=0.002、0.001、0.037)；PCT、PLT水平在两组中差异无统计学意义(P >0.05)。各临床指标在关闭组与持续开放组中差异无统计学意义(P>0.05)。当NSE处于57.28 ng/mL时,灵敏度0.600,特异度0.618；BNP处于2 430.00 pg/mL 时,灵敏度0.800,特异度0.618；cTnT处于67.70 pg/mL 时,灵敏度0.680,特异度0.618,需要药物干预。结论 血浆BNP、cTnT、NSE在早期预测早产儿PDA及指导药物治疗方面具有重要意义。 |
| 英文摘要: |
| Objective To explore the clinical indicators for early prediction of patent ductus arteriosus (PDA) in premature infants.Methods Sixty-one premature infants (gestational age<37 weeks) in Yuebei People's Hospital affiliated to Shantou University Medical College within 24 hours after birth from January 2017 to December 2017 were selected by a prospective observational study.26 preterm infants with sPDA were selected as the observation group and 35 preterm infants without sPDA were selected as the control group.The observation group received oral treatment with Ibuprofen suspension,and the first course of treatment ended.After reviewing the echocardiography,there were still sPDAs in the continuous open group and no sPDA in the closed group.The plasma B-type natriuretic peptide (BNP),cardiac troponin T (cTnT),procalcitonin (PCT),neuron-specific enolase (NSE) and platelet (PLT) count were measured after birth.The differences between clinical indexes of the observation group,the control group,the continuous open group and the closed group were compared.The indicators of drug intervention were established by ROC curve.Results The plasma BNP,cTnT and NSE in the observation group were higher than those in the control group [(3 483.00±1 560.11) pg/m vs.(2 380.65±1 105.15) pg/mL,(89.17±35.67)pg/mL vs.(62.62±17.89)pg/mL,and (100.06±84.81) ng/mL vs.(60.69±35.17)ng/mL;P=0.002,0.001,0.037),there were no significant differences in PCT and PLT levels between the two groups.There was no significant difference in clinical indicators between closed group and continuous open group (P>0.05).When NSE was 57.28 ng/mL,sensitivity was 0.600 and specificity was 0.618;when BNP was 2 430.00 pg/mL,sensitivity was 0.800 and specificity was 0.618;when cTnT was 67.70 pg/mL,sensitivity was 0.680 and specificity was 0.618,requiring drug intervention.Conclusion The plasma BNP,cTnT and NSE are of great significance in early prediction and the guidance of drug therapy of patent ductus arteriosus in premature infants. |
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