| 王彤,张芳,杨国颖.新生儿支气管肺发育不良病儿外周血信号转导及转录活化因子3、内皮素 -1表达及临床意义[J].安徽医药,2023,27(12):2475-2478. |
| 新生儿支气管肺发育不良病儿外周血信号转导及转录活化因子3、内皮素 -1表达及临床意义 |
| Expression and clinical significance of peripheral blood STAT3 and endothelin-1 in children with neonatal bronchopulmonary dysplasia |
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| DOI：10.3969/j.issn.1009-6469.2023.12.031 |
| 中文关键词: 支气管肺发育不良 信号转导及转录活化因子 3 内皮素 -1 身体质量指数 婴儿，新生 |
| 英文关键词: Bronchopulmonary dysplasia Signal transducer and activator of transcription 3 Endothelin-1 Body mass index Infant, newborn |
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| 目的探究新生儿支气管肺发育不良( BPD)病儿外周血信号转导及转录活化因子3( STAT3)、内皮素 -1表达水平及临床意义。方法选取 2019年 3月至 2021年 3月唐山市妇幼保健院新生儿科收治的 93例早产儿为研究对象，根据 BPD诊治标准分为 BPD组病儿 51例，非 BPD组病儿 42例。收集所有病儿的一般临床资料并分析。采用酶联免疫吸附测定( ELISA)检测病儿不同时期(出生后第 1天、第 14天、第 28天)的血清 STAT3、内皮素 -1水平。受试者操作特征( ROC)曲线分析血清 STAT3、内皮素 -1对 BPD的诊断价值。多因素 logistic分析新生儿发生 BPD的危险因素。结果 BPD组与非 BPD组病儿性别、产妇产前感染、院内感染之间的差异无统计学意义( P>0.05)胎龄、出生体质量、合并肺炎、合并贫血、呼吸暂停、宫内感染、动脉导管未闭、机械通气时间之间差异有统计学意义( P<0.05)。组，间比较: BPD组病儿血清 STAT3、内皮素 -1水平第 1天［(1.92± 0.54)ng/L、(108.74±21.64)ng/L］、第 14天［( 1.43±0.37)ng/L、(83.16±16.34)ng/L］、第 28天［( 1.01±0.19)ng/L、(59.69±9.46)ng/L］均高于非 BPD组［( 1.16±0.25)ng/L、(65.16±10.62)ng/L，(0.98±0.18)ng/L、(54.34±9.11)ng/L，(0.80±0.16)ng/L、(46.78±7.84)ng/ L］差异有统计学意义( P<0.05)；组内比较:第 14天、第 28天两组病儿血清 STAT3、内皮素 -1水平均低于第 1天，第 28天两组病儿血清，STAT3、内皮素 -1水平均低于第 14天，差异有统计学意义( P<0.05)。 ROC曲线分析显示，血清 STAT3、内皮素 -1对 BPD诊断价值的曲线下面积( AUC)分别为 0.83、0.85，截断值分别为 1.65 ng/L、73.57 ng/L，灵敏度分别为 60.80%、92.20%，特异度分别为 95.20%、81.00%。多因素 logistic回归分析显示合并肺炎、机械通气时间 ≥7 d及高水平的 STAT3和内皮素 -1是新生儿发生 BPD的独立危险因素( P<0.05)而出生体质量 1 000~1 250 g、>1 250~<1 500 g是新生儿发生 BPD的保护因素( P<0.05)。结论 BPD病儿血清 STAT3、内皮素 -1水，平呈异常表达，且对新生儿发生 BPD存在较高的诊断价值，血清 STAT3、内皮素 -1动态水平 |
| 英文摘要: |
| Objective To explore the expression levels and clinical significance of peripheral blood signal transducer and activatorof transcription 3 (STAT3) and endothelin-1 in children with neonatal bronchopulmonary dysplasia (BPD).Methods Ninety-three pre.mature infants admitted to the Department of Neonatology, Tangshan Maternal and Child Health Hospital from March 2019 to March2021 were selected as the study subjects. According to the diagnosis and treatment criteria of BPD, 51 cases were divided into the BPDgroup, and 42 cases were divided into the non-BPD group. General clinical data of all infants were collected and analyzed. Serum STAT3 and endothelin-1 levels were detected by enzyme-linked immunosorbent assay (ELISA) at different periods (postnatal day 1, day14 and day 28). The diagnostic value of serum STAT3 and endothelin-1 for BPD was analyzed by receiver operating characteristic(ROC) curves. Multivariate logistic analysis of risk factors for the development of BPD in neonates.Results There were no statistically significant differences between the BPD group and the non-BPD group in terms of sex, prenatal and nosocomial infection of the mothers (P>0.05), while there were statistically significant differences in terms of gestational age, birth weight, copneumonia, coanemia, apnea,intrauterine infection, patent ductus arteriosus, and mechanical ventilation time (P<0.05). Comparison between groups: serum STAT3 and endothelin-1 levels in children in the BPD group were [(1.92±0.54) ng/L and (108.74±21.64) ng/L] on day 1, [(1.43±0.37) ng/L and(83.16±16.34) ng/L] on day 14, and [(1.01±0.19) ng/L and (59.69±9.46) ng/L] on day 28 L, which were higher than those in the non-BPD group [(1.16±0.25) ng/L, (65.16±10.62) ng/L, (0.98±0.18) ng/L, (54.34±9.11) ng/L, (0.80±0.16) ng/L, (46.78±7.84) ng/L], and thedifferences were statistically significant (P<0.05). Intragroup comparison: serum STAT3 and endothelin-1 levels were lower in both groups on days 14 and 28 than on day 1, serum STAT3 and endothelin-1 levels were lower in both groups on day 28 than on day 14, and the difference was statistically significant (P<0.05). ROC curve analysis showed that the areas under the curve (AUC) of serum STAT3 and endothelin-1 for the diagnosis of BPD were 0.83 and 0.85, with cutoff values of 1.65 ng/L and 73.57 ng/L, sensitivities of 60.80%and 92.20%, and specificities of 95.20% and 81.00%, respectively. Multivariate logistic regression analysis showed that complicatedpneumonia, mechanical ventilation duration ≥ 7 days and high levels of STAT3 and endothelin-1 were independent risk factors for neo. natal BPD (P<0.05), while birth weights of 1 000-1 250 g, and > 1 250-< 1 500 g were protective factors for neonatal BPD (P<0.05). Conclusion Serum STAT3 and endothelin-1 levels in children with BPD are abnormally expressed, and there exists a high diagnosticvalue for the occurrence of neonatal BPD. The dynamic levels of serum STAT3 and endothelin-1 are of great significance for the early detection of BPD and early intervention and treatment. |
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