Objective To explore the clinical value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin Ⅰ(cTnⅠ) in evaluating the prognosis of neonatal respiratory distress syndrome (NRDS),in order to provide reference for clinical practice. Methods Totally 110 children with NRDS hospitalized in Yulin First Hospital from April 2015 to April 2018 were enrolled in this study as the case group,and 60 infants without NRDS in the meantime were selected as control.Children with NRDS were divided into survival group and death group according to the prognosis.Differences on general clinical data among each group were compared.Logistic regression equation was used to analyze the relationship between the death of NRDS children and the levels of NT-proBNP and cTnⅠ.And ROC curve was used to evaluate the predictive value of NRDS. Results Plasma levels of NT-proBNP and cTnⅠ in case group were significantly higher than those in control group(t=24.329,51.075,P＜0.05).Compared with survival group,birth weight,oxygen index (PaO2/FiO2) were lower and the levels of creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) were significantly higher in the death group(P＜0.05).Plasma levels of NT-proBNP and cTnⅠ in death group were significantly higher than those in survival group (P<0.05).NT-proBNP and cTnⅠ levels in children with grade Ⅳ NRDS were significantly higher than those in children with grade Ⅰ-Ⅲ NRDS,so was in grade Ⅲ NRDS than those in grade Ⅰ-Ⅱ NRDS (P<0.05).Spearman rank correlation analysis indicated that the levels of NT-proBNP and cTnⅠ were positively correlated with NRDS severity respectively (r=0.329,0.287,P<0.05).Multiple Logistic regression equation suggested that NT-proBNP (OR=3.115,95%CI:2.249-7.184) and cTnⅠ(OR=2.376,95%CI:1.582-6.110) were risk factors of death (P<0.05).The area under ROC curve of NT-proBNP and cTnⅠ in predicting death of NRDS children was 0.769 and 0.691,respectively.The area under the ROC curve predicted by the two groups was significantly higher than that predicted by the two groups alone (Z=2.854,P<0.05). Conclusions The levels of NT-proBNP and cTnⅠ are positively correlated with the severity of NRDS,which may be risk factors for the death of NRDS children.Moreover,the combined detection of NT-proBNP and cTnⅠ levels has a high clinical value in predicting the prognosis.
Key words
N-terminalpro-brainnatriureticpeptide /
cardiactroponinⅠ /
neonatalrespiratorydistresssyndrome
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