1 徐州医科大学附属医院新生儿科，江苏 徐州 221002
目的：通过检测前B细胞集落增强因子(pre-B cell colony-enhancing factor，PBEF)和脂联素(adiponectin，APN)在支气管肺发育不良(bronchopulmonary dysplasia，BPD)患儿血浆中的表达水平，以评估PBEF和APN在BPD中的早期诊断价值。方法：采用前瞻性队列研究方法，选择2018年3月至2019年10月在新生儿重症监护室住院的胎龄28~32周、出生体重<1 500 g的86例早产儿为研究对象。采集患儿出生后第1、7、14天血标本，用ELISA方法检测血浆中PBEF和APN浓度。根据BPD的诊断标准将患儿分为BPD组与非BPD组，其中BPD组32例，非BPD组54例。结果：生后第1、7、14天，两组PBEF表达水平均逐渐升高，且BPD组(分别96.72±15.54、108.29±16.16、119.40±16.23)的表达水平均高于非BPD组(分别85.71±15.47、93.91±12.00、101.53±13.76)，差异有统计学意义(P<0.05)；出生后第1、7、14天，两组APN表达水平均逐渐升高，且BPD组(分别60.99±9.86、66.77±9.29、83.05±10.96)的表达水平均低于非BPD组(分别67.13±7.37、81.70±8.25、92.82±9.72)，差异有统计学意义(P<0.05)。ROC曲线分析显示：出生后第1、7、14天，APN曲线下面积分别为0.686、0.867、0.744；PBEF曲线下面积分别为0.687、0.751、0.774；APN联合PBEF曲线下面积分别为0.777、0.938、0.859(均P<0.05)。不同时点APN、PBEF以及APN联合PBEF对BPD的预测价值均有统计学意义。结论：早产儿生后早期血浆PBEF和APN水平的变化，可为BPD的发生提供早期预测依据。
Expression and significance of pre-B cell colony-enhancing factor and adiponectin in premature infants with bronchopulmonary dysplasia
CorrespondingAuthor: WANG Jun
This work was supported by Jiangsu Provincial Maternal and Child Health Research Project, China (F201850).
Objective: To evaluate the early diagnostic value of pre-B cell colony-enhancing factor (PBEF) and adiponectin (APN) in bronchopulmonary dysplasia (BPD) by detecting the expression level of PBEF and APN in the plasma of children with BPD. Methods: A prospective cohort study was used to select 86 premature infants with a birth weight of less than 1 500 g for 28 to 32 weeks in the Neonatal Intensive Care Unit from March 2018 to October 2019. Blood samples were collected at 1st, 7th and 14th d after birth, and the plasma PBEF and APN concentration were measured by ELISA. According to the diagnostic criteria of BPD, the infants were divided into a BPD group and a non-BPD group, including 32 cases in BPD group and 54 cases in non-BPD group. Results: At 1st, 7th and 14th d after birth, the expression level of PBEF in both groups increased gradually. The expression level of PBEF in the BPD group (96.72±15.54, 108.29±16.16, 119.40±16.23, respectively) was higher than that in the non-BPD group (85.71±15.47, 93.91±12.00, 101.53±13.76, respectively) at each time point, and the difference was statistically significant (P<0.05). At 1st, 7th and 14th after birth, the expression level of APN in both groups increased gradually. However, the expression level of APN in the BPD group (60.99±9.86, 66.77±9.29, 83.05±10.96, respectively) were lower than that in the non-BPD group (67.13±7.37, 81.70±8.25, 92.82±9.72, respectively) at each time point, and the difference was statistically significant (P<0.05). The ROC curve analysis showed that at 1st, 7th and 14th after birth, the area under the curve of APN respectively was 0.686, 0.867, and 0.744; the area under the curve of PBEF respectively was 0.687, 0.751, and 0.774; when combing APN and PBEF, the area under the curve respectively was 0.777, 0.938, and 0.859. The predictive value of APN, PBEF, and APN combined with PBEF at different time points for BPD was statistically significant (all P<0.05). Conclusion: The changes of plasma PBEF and APN in the early stage of prematurity can provide an early prediction basis for the occurrence of BPD.
premature infants; bronchopulmonary dysplasia; pre-B cell colony-enhancing factor; adiponectin