摘要
目的研究水通道蛋白-5(AQP-5)表达水平与新生儿呼吸窘迫症(NRDS)临床特征及预后的关联。方法选取2018年01月至2019年12月NRDS患儿120例进行治疗并做预后评估,采用ELISA法(酶联免疫吸附)测定不同预后状态患儿的血清AQP-5浓度,并绘制AQP-5的ROC曲线,进一步评估NRDS的预后价值;所有患儿根据ROC曲线的预测临界值分为低风险组和高风险组,比较两组患儿的治疗情况、并发症及转归情况;考察AQP-5表达与临床数据关联;COX多因素回归确定NRDS预后的关键影响因素。结果不同预后患儿的血清AQP-5水平差异有显著性(P<0.05),AQP-5水平越高,提示预后越差;以AQP-5水平2.42μg/L作为预测的临界值,ROC曲线下面积为0.867,灵敏度为75.9%,特异度为88.3%;根据预测的临界值,分为低风险组(AQP-5浓度≤2.42μg/L)88例和高风险组(AQP-5浓度>2.42μg/L)32例;低风险组患儿所需的氧疗时间、使用PS例数及其住院时间都要少于高风险组(P<0.05),且具有更少并发疾病,疾病预后及转归效果均明显好于高风险组(P<0.05);单因素分析显示,胎龄、分娩方式、出生窒息、胎盘异常、阿氏评分(Apgar评分)及妊娠高血压对NRDS预后具有显著影响(P<0.05);COX回归可知,AQP-5水平(Hr=4.685,95%CI1.833~11.974)、胎龄(Hr=4.125,95%CI1.182~14.396)、分娩方式(Hr=2.680,95%CI1.081~6.646)、胎盘异常(Hr=3.017,95%CI1.242~7.328)及Apgar评分(Hr=3.278,95%CI1.486~7.231)是NRDS患儿预后的独立危险因素。结论AQP-5与NRDS临床特征密切相关,可以作为NRDS预后的标志物。
Objective To investigate the relationship of aquaporin-5(AQP-5)expression with clinical features and prognosis of neonatal respiratory distress syndrome(NRDS).Methods 120 children diagnosed with NRDS from January 2018 to December 2019 were selected for treatment and prognosis evaluation,.The serum AQP-5 concentration was measured by ELISA(enzyme-linked immunosorbent assay).The ROC curve of AQP-5 on the prognosis of NRDS was drawn to further evaluate the prognostic value of NRDS.According to the critical value of the ROC curve,the predictive value of NRDS was further evaluated.All the children were divided into the low-risk group and the high-risk group.The treatment,complications and outcomes of the two groups were compared.The correlation between AQP-5 expression and clinical data was investigated by single factor analysis.Finally,the key factors of NRDS prognosis were analyzed by COX multivariate regression.Results The serum AQP-5 level of children with different prognosis was significantly different(P<0.05).The higher the AQP-5 level,the worse the prognosis.The AQP-5 level of 2.42μg/l was used as the critical value for prediction.The area under the ROC curve of AQP-5 was0.867,the sensitivity was 75.9%,and the specificity was 88.3%.According to the predicted critical value,88 cases were divided into the low-risk group(AQP-5 concentration≤2.42μg/L)and 32 cases were the high-risk group(AQP-5 concentration>2.42μg/L).The time of oxygen therapy,the number of patients using PS and the duration of hospital stay in the low-risk group were less than those in the high-risk group(P<0.05),and it had fewer complications.The prognosis and outcome of the disease were significantly better than those of the high-risk group(P<0.05).Univariate analysis showed that gestational age,mode of delivery,birth asphyxia,placental abnormalities,Apgar score(Apgar score)and pregnancy induced hypertension had significant influence on the prognosis of NRDS(P<0.05).COX regression showed that AQP-5 level(Hr=4.685,95%CI 1.833-11.974),gestati
作者
王叶青
郄学敏
姚爱敏
王媛媛
吴月红
WANG Ye-qing;QIE Xue-min;YAO Ai-min;WANG Yuanyuan;Wu Yue-hong(the Second Department of Newborn,Baoding Maternal and Child Health Hospital,Baoding,Hebei 071000,China)
出处
《临床肺科杂志》
2021年第7期1012-1017,共6页
Journal of Clinical Pulmonary Medicine
关键词
AQP-5
新生儿呼吸窘迫症
临床特征
预后
AQP-5
neonatal respiratory distress syndrome
clinical features
prognosis
