Abstract:ObjectiveTo investigate the predictive value of serum B-type natriuretic peptide (BNP) to meconium aspiration syndrome (MAS) with persistent pulmonary hypertension of the newborn (PPHN). MethodsIt was a prospective cohort study, 86 infants were enrolled in the NICU from January 2017 to March 2019. Infants of MAS were classified into the PPHN group (n=26) and non-PPHN group (n=60), all infants were collected data in perinatal period. Serum BNP levels were detected in the 24-48 hours after birth. When the condition of the MAS infants was aggravated, serum BNP levels, blood gas analysis, chest X-ray and echocardiography were detected. BNP levels and OI, A-aDO2 were compared between PPHN group and non-PPHN group. ResultsBNP levels in PPHN group [1049.87(787.95,1484.50)ng/L] were significantly different with those in non-PPHN group [344.15(302.75,510.25)ng/L] in the 24-48 hours after birth(U=68.50,P<0.01). In the infants with PPHN, significantly higher increases were found in BNP levels [1435.45(986.50,1869.20)ng/L] and A-aDO2 [(535.72±82128)mmHg] compared with those in non-PPHN group [632.54(479.35,867.23)ng/L,(388.75±78.78)mmHg] when the condition was aggravated (U=57.75,t=5.83,all P<0.01). But there was no significant difference in OI (20.38±3.88,21.62±4.86) between the two groups (t=0.86,P>0.05). ROC curve was used to analyze the diagnostic efficacy of BNP level for PPHN combined with MAS. The area under the curve was 0.956 (95%CI:0.889~0.989). The optimum threshold BNP level was 652ng/L, the sensitivity of predicting PPHN was 88.46%, and the specificity was 95.00%. ConclusionIn the MAS infant, BNP had excellent sensitivity and specificity in predicting PPHN, which maybe a useful early diagnosis biomarker.
田玉红 常艳华 王瑜. B型尿钠肽对新生儿胎粪吸入综合征合并持续性肺动脉高压的诊断价值[J]. 中华诊断学电子杂志, 2020, 8(1): 57-61.
Tian Yuhong, Chang Yanhua, Wang Yu. The predictive value of B-type natriuretic peptide to meconium aspiration syndrome with persistent pulmonary hypertension of the newborn. zhzdx, 2020, 8(1): 57-61.