早产儿支气管肺发育不良的影响因素及血清MMP-16、NF-κB检测的临床意义

目的:探讨早产儿支气管肺发育不良(BPD)的影响因素及血清基质金属蛋白酶-16(MMP-16)、核因子κB(NF-κB)检测的临床意义。方法:前瞻性选取2014年8月~2019年2月期间我院收治的早产儿196例,将早产儿根据是否发生BPD分为无BPD组(n=109)和BPD组(n=87)。将BPD组根据校正胎龄36周或出院时是否需氧分为轻度BPD组(n=28)、中度BPD组(n=30)、重度BPD组(n=29)。采用酶联免疫吸附法检测血清MMP-16、NF-κB水平,采用Pearson相关性分析MMP-16与NF-κB的关系,采用多因素Logistic回归分析早产儿BPD的影响因素。结果:随着BPD病情严重程度的增加,血清MMP-16、NF-κB水平呈不断升高趋势(P<0.05)。Pearson相关性分析可得,MMP-16与NF-κB呈正相关(P<0.05)。单因素分析结果显示,早产儿BPD的发生与出生体质量、胎龄、有无羊水污染、孕母有无妊娠期高血压、有无早产儿呼吸窘迫综合征、使用或未使用肺表面活性物质、有无肺出血、闭合或未闭合动脉导管、有无机械通气、是否吸入氧浓度>40%有关(P<0.05),而与性别、胎膜早破史无关(P>0.05)。多因素Logistic回归分析显示,胎龄为28~31周、动脉导管未闭合、使用肺表面活性物质、机械通气、羊水污染、出生体质量为1000~1500 g均是早产儿BPD发生的独立危险因素(P<0.05)。结论:早产儿BPD体内血清MMP-16、NF-κB水平呈异常升高,可能参与着疾病的发生、发展,BPD与多种因素息息相关,可采取积极的预防措施以减少BPD的发生。

Influencing Factors of Bronchopulmonary Dysplasia in Premature Infants and Clinical Significance of Serum MMP-16 and NF-κB Detection

Objective: To investigate the influencing factors of bronchopulmonary dysplasia(BPD) in premature infants and the clinical significance of detection of matrix Metalloproteinase-16(MMP-16) and nuclear factor-κB(NF-κB) in serum. Methods: Prospective selection of 196 cases of premature infants who were admitted to our hospital from August 2014 to February 2019, Premature infants were divided into non-BPD group(n=109) and BPD group(n=87) according to whether BPD occurred or not. The BPD group was divided into mild BPD group(n=28), moderate BPD group(n=30) and severe BPD group(n=29) according to the corrected gestational age of 36 weeks or whether oxygen demand was present at discharge. Serum levels of MMP-16 and NF-κB were detected by enzyme-linked immunosorbent assay, the relationship between MMP-16 and NF-κB was analyzed by Pearson correlation analysis, and the influencing factors of BPD in premature infants were analyzed by multivariate logistic regression analysis. Results: With the increase of the severity of BPD, the levels of serum MMP-16 and NF-κB increased(P<0.05). Pearson correlation analysis showed that MMP-16 was positively correlated with NF-κB(P<0.05). Univariate analysis showed that the occurrence of BPD in premature infants were related to birth weight,gestational age, amniotic fluid contamination, pregnant women with or without gestational hypertension, yes or no respiratory distress syndrome of premature infants, use or non-use of pulmonary surfactant, yes or no pulmonary hemorrhage, closed or unclosed ducts of arteries, yes or no mechanical ventilation, whether or not inhalation of oxygen concentration>40%(P<0.05). It was not related to gender and the history of premature rupture of membranes(P>0.05). Logistic regression analysis showed that gestational age of 28-31 weeks,unclosed ducts of arteries, use of pulmonary surfactant, mechanical ventilation, amniotic fluid contamination and body mass of1000-1500 g were independent related factors of BPD in premature infants(P<0.05). Conclusion: The serum levels of MMP-16 and NF-κB in premature infants with BPD are abnormally elevated, which may be involved in the occurrence and development of the disease.Clinical data confirm that BPD is closely related to many factors, and positive measures can be taken to prevent and reduce the occurrence of BPD.