Objective:To study the early predictive values of serum thrombospondin-1(TSP-1)and transforming growth factor-β1(TGF-β1) for bronchopulmonary dysplasia(BPD)in preterm infants.Methods:From September 2020 to April 2022, preterm infants with gestational age<32 weeks and ≥28 weeks as well as birth weight<1 500 g admitted to neonatal intensive care unit within 2 hours after birth were enrolled in the study.The dynamic changes of serum TSP-1 and TGF-β1 levels in preterm infants were observed on 1st, 7th, 14th, and 28th day after birth.Preterm infants were divided into BPD group and non-BPD group according to the diagnostic criteria of BPD.Receiver operating characteristic(ROC) curve and area under curve(AUC)was used to analyze the predictive value of serum TSP-1 and TGF-β1 for preterm infants with BPD.Results:According to the diagnostic criteria of BPD, 38 cases were in the BPD group and 52 cases in the non-BPD group.There was no significant difference in gestational age, birth weight and gender between the two groups( P>0.05). The levels of TSP-1 and TGF-β1 in the serum of BPD group were gradually increased, which were significantly higher than those of non-BPD group on the 1st, 7th, 14th, and 28th day( P<0.001). ROC results showed that AUC of TSP-1, TGF-β1 and their combination for predicting BPD were 0.889(95% CI 0.819~0.959), 0.826(95% CI 0.743~0.910), and 0.923(95% CI 0.870~0.976), respectively.The sensitivity were 86.80%, 86.70%, 89.50%, and the specificity were 86.50%, 73.10%, 80.80%, respectively.Cutoff values of TSP-1 and TGF-β1 for predicting BPD were 44.50 μg/L and 6.13 μg/L, respectively. Conclusion:Combined detection of serum TSP-1 and TGF-β1 on the first day after birth has an early predictive value for BPD in preterm infants.

目的 分析红细胞分布宽度(RDW)与早中期早产儿新生儿呼吸窘迫综合征(NRDS)严重程度及其预后的相关性.方法 胎龄≥28周且<34周确诊NRDS的早产儿264例,依据入院24 h内首次胸片结果评估NRDS严重程度分为轻度组(214例)和重度组(50例),根据有无并发症或死亡分为预后良好组(134例)及预后不良组(130例).分析早产儿出生后24 h的RDW水平与NRDS疾病严重程度及预后的关系.结果 重度组早产儿RDW水平高于轻度组(P<0.05).预后不良组RDW水平高于预后良好组(P<0.05).多因素logistic回归分析显示,出生时较高RDW水平是早中期早产儿发生重度NRDS和预后不良的独立危险因素[OR=1.677,95％CI(1.294～2.172)和OR=1.353,95％CI(1.051～1.742)](P<0.05).结论 出生后早期高水平RDW的早中期早产儿发生严重NRDS及预后不良的风险更大.

目的 观察脑损伤早产儿血清25-羟维生素D[25-(OH)D]水平的变化情况,探讨其与炎症反应的关系.方法 选择生后24 h内入住NICU的53例早产儿,其中发生脑损伤24例(观察组),未发生脑损伤29例(对照组).采集两组生后第1、7、14天桡动脉血,采用ELISA法检测血清25-(OH)D及IL-17、IL-10水平,分析血清25-(OH)D与IL-17、IL-10的相关性.结果 两组血清25-(OH)D水平在生后第1、7天较低,第14天逐渐升高,观察组各时间点25-(OH)D水平均低于对照组(P均<0.05).观察组第7天IL-17水平高于第1、14天(P均<0.05),第14天与第1天差异无统计学意义(P>0.05),观察组各时间点IL-17水平均高于对照组(P均<0.05).观察组第14天IL-10水平高于第1、7天(P均<0.05),对照组IL-10水平第7天低于第1天、第14天低于第7天(P均<0.05).观察组血清25-(OH)D水平在生后第1、7、14天与IL-17水平均呈负相关(P均<0.05),在第1、7天与IL-10水平呈正相关(P均<0.05).结论 脑损伤早产儿生后各时间点血清25-(OH)D水平均较低,其水平变化与IL-17、IL-10水平相关;补充维生素D或可抑制脑损伤后的炎症反应.

目的 探讨血清血红素氧合酶-1(HO-1)、高迁移率族蛋白B1(HMGB1)在早产儿支气管肺发育不良(BPD)发病中的作用及近期神经系统发育评估中的价值.方法 选取2019年12月至2021年3月徐州医科大学附属医院新生儿重症监护室收治的96例早产儿作为研究对象.根据BPD诊断标准分为BPD组40例和非BPD组56例.根据矫正胎龄36周时需吸入氧浓度(FiO2)情况将BPD组分为轻度亚组(未用氧)、中度亚组(FiO2<30％)及重度亚组(FiO2≥30％或需机械通气).采用ELISA法检测两组早产儿出生后第1、7、14、28天血清HO-1、HMGB1水平,于出生后1周内及矫正胎龄40周时监测振幅整合脑电图(aEEG)评分.比较两组早产儿出生后第1、7、14、28天血清HO-1和HMGB1水平和出生后1周内及矫正胎龄40周时aEEG评分,同时分析BPD组早产儿血清HO-1、HMGB1水平与aEEG评分的相关性.结果 BPD组早产儿出生后第7、14、28天血清HO-1、HMGB1水平均高于非BPD组,差异均有统计学意义(均P<0.05);而两组早产儿出生后第1天血清HO-1、HMGB1水平比较差异均无统计学意义(均P>0.05).BPD轻度、中度及重度亚组早产儿出生后1周内、矫正胎龄40周时aEEG评分均低于非BPD组,差异均有统计学意义(均P<0.05);BPD中度及重度亚组早产儿出生后1周内、矫正胎龄40周时aEEG评分均低于轻度亚组,重度亚组早产儿出生后1周内、矫正胎龄40周时aEEG评分均低于中度亚组,差异均有统计学意义(均P<0.05).BPD组出生后第7天血清HO-1、HMGB1水平与出生后1周内aEEG评分均呈负相关(均P<0.01),出生后第7、14、28天血清HO-1、HMGB1水平与矫正胎龄40周时aEEG评分均呈负相关(均P<0.01).结论 HO-1、HMGB1可能与早产儿BPD的形成有关,并可能影响早产儿的近期神经系统发育.