Objective To explore the role of serum neutrophil gelatinase-associated carrier protein(NGAL), interleukin 33(IL-33), and tumor necrosis factor alpha(TNF-α) in the early prediction of bronchopulmonary dysplasia(BPD) in very preterm infants. Methods The very premature infants admitted in Maternal and Child Health Hospital of Anhui Medical University from March 2018 to September 2019 were enrolled in this study and were divided into BPD group and non-BPD group according to the diagnostic criteria.The serum levels of IL-33, TNF-α and NGAL on the 1st, 14th and 28th day after birth were tested for comparative analysis, and receiver operating characteristic(ROC) curves were prepared to obtain early predictive efficacy of various indicators. Results 1) A total of 66 very premature infants were included, of whom 25 cases(37.9%) were in the BPD group, including 15 cases of mild BPD, 8 cases of moderate BPD, and 2 cases of severe BPD.2) The serum levels of IL-33, TNF-α and NGAL in the BPD group at different time periods were significantly higher than those in the non-BPD group(P<0.05), and the expression levels of the three indicators gradually increased during 14 days after birth(P<0.05).3) Children in severe BPD group had significantly higher levels of serum IL-33 on the 14th days and 28th days after birth than those with mild to moderate BPD(F=8.220, 15.763, P<0.05).4) ROC curve showed that the areas under curve(AUC) of serum levels of NGAL, IL-33, TNF-α on the 1st and 14th day after birth were 0.768, 0.752, 0.760, 0.875, 0.978 and 0.975, respectively. Conclusions IL-33, NGAL, and TNF-α are all early predictors of BPD, with the highest prediction efficiency of NGAL level on the 1st day after birth, and highest prediction efficiency of IL-33 level on the 14th day.Moreover, IL-33 may also be used as an indicator to assess the severity of BPD.
Key words
bronchopulmonary dysplasia /
early prediction /
very premature
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