Clinical Value Of Serum SP-D、ESM-1 Early Prediction Of Bronchopulmonary Dysplasia In Premature Infants

Objective:As the level of neonatal treatment increases,the survival rate of premature infants increases significantly,and the incidence of bronchopulmonary dysplasia(BPD)is also rising.It is not only reduces the survival rate and quality of life of children,but also brings great challenges and burdens to families and society.It is not conducive to the improvement of social and demographic quality.BPD occurrence and development mechanism have become the focus of many scholars at home and abroad in recent years.More and more studies show that many cytokines participate in its occurrence and development process and play an important role.In this study,the changes of serum SP-D and ESM-1 levels in bronchopulmonary dysplasia of premature infants were studied,aiming to explore the clinical value of serum SP-D and ESM-1 in early prediction of bronchopulmonary dysplasia of premature infants,in order to provide some theoretical reference for clinical diagnosis and treatment.Methods:To collect general clinical data of mechanically ventilated premature infants(including mode of delivery,sex,birth weight,gestational age)and serum after birth 1d,7d,14 d from July 2019 to December 2020.Determination of serum SP-D,ESM-1 by Enzyme linked immunosorbent assay(ELISA).The patients were divided into BPD group and non-BPD group according to the need of oxygen inhalation at 28 days of age.Application SPSS 24.0 to analyze the obtained data.Number and percentage of cases used to describe measurement data,The chi-square test was used to compare the groups;Measurement data conforming to the normality test are expressed as mean±standard deviation(x±s),Intergroup comparisons,two-independent sample t test for homogeneity of variance,An approximate t test is used for variance discrepancy;repeated measurement ANOVA was used for intra-group comparisons;By mapping the Receiver Operating Characteristic Curves,area under curve(AUC)size,the optimal threshold value,sensitivity and specificity of serum SP-D,ESM-1 for predicting bronchopulmonary dysplasia were calculated by Excel.AUC greater than 0.7 indicates diagnostic value.P<0.05 indicates that the difference is statistically significant.Result:1.The general data of the two groups were compared: this study included 54 subjects,6 cases were withdrawn(1 death,1 abandonment and 4 transfer),48 cases were actually enrolled,including 21 cases in BPD group and 27 cases in non-BPD group.There was no significant difference in the general data of the two groups:delivery mode,sex,birth weight and gestational age(P>0.05).2.On the first day after birth,the serum SP-D content of BPD group and non-BPD group was similar,but there was no significant difference between the two groups(P>0.05),On the 7th day and the 14 th day after birth,the serum SP-D content of the BPD group was higher than that of the non-BPD group,and the difference between the two groups was statistically significant(P<0.05).The serum SP-D content of the two groups on the 7th and 14 th days after birth was higher than that on the 1st day after birth,and the SP-D content on the 14 th day after birth was higher than that on the 7th day.Only BPD groups had significant differences at different time points(P<0.05).3.On the 1st day after birth,the serum ESM-1 content of BPD group and non-BPD group was similar,there was no significant difference between the two groups(P>0.05);On the 7th and 14 th days after birth,the serum ESM-1 content of BPD group was higher than that of non-BPD group,and the difference between the two groups was statistically significant(P<0.05).The serum ESM-1 content of the two groups increased on the 7th and 14 th days after birth,and the serum SP-D content on the 14 th day after birth was higher than that on the 7th day.Only BPD groups had significant differences at different time points(P<0.05).4.Taking 1-specificity as abscissa,sensitivity as ordinate,draw the Receiver Operating Characteristic Curves of serum SP-D,ESM-1 and their combined subjects:the area under curve of serum SP-D content was 0.796,sensitivity was 0.857,specificity was 0.630,critical value was 59.60 ng/ml;the area under curve of serum ESM-1 content was 0.789,sensitivity was 0.786,specificity was 0.722,critical value was 26.05 ng/ml;the combined area under curve was 0.874,sensitivity was 0.881,specificity is was 0.723.Conclusion:1.The serum levels of SP-D and ESM-1 can reflect the development of BPD and lung injury in premature infants to a certain extent.2.The combined prediction efficacy of serum SP-D and ESM-1 is higher than that of single serum SP-D or ESM-1 in terms of sensitivity and specificity,and the prediction efficacy is better,which may provide some reference basis for the early clinical diagnosis of BPD,and it has certain clinical guiding value for timely taking intervention measures,improving the prognosis,improving the survival rate and quality of life of children.