Application value of plasma N-terminal pro-B-type natriuretic peptide in diagnosis and treatment of symptomatic ;patent ductus arteriosus in preterm infants
10.3969/j.issn.1000-3606.2016.03.002
- VernacularTitle:血N端脑钠肽前体在早产儿症状性动脉导管未闭诊治中的应用价值
- Author:
Xiaoqin GONG
;
Huabao PENG
;
Qun ZENG
;
Zhanghua HOU
;
Xiaomin KUANG
- Publication Type:Journal Article
- Keywords:
patent ductus arteriosus;
N-terminal pro-B-type natriuretic peptide;
very low birth weight infant;
preterm infant
- From:
Journal of Clinical Pediatrics
2016;34(3):166-171
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical application value of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in diagnosis and treatment of symptomatic patent ductus arteriosus (sPDA) in preterm infants. Methods A total of 107 preterm infants with gestational age of 28-32 weeks and birth weight less than 1500 g who were admitted to the neonatal intensive care unit from October 2013 to September 2014 were recruited. Plasma NT-proBNP were on 4th and 7th day after birth. The echocardiography examination was performed within 30 minutes after the blood was drawn. According to the echocardiography examination on 4th day after birth, the infants were divided into the patent ductus arteriosus (PDA) group (n?=?39) and the control group (n?=?68). According to whether there were signiifcant hemodynamics changes of ultrasonography and clinical symptoms, the PDA group were classiifed into the sPDA group (n?=?20) and the asymptomatic PDA group (asPDA, n?=?19). Then according to whether ibuprofen was taken, the sPDA group was further divided into treatment group (n?=?13) and non-treatment group (n?=?7). Results On the 4th day after birth, the level of plasma NT-proBNP in the sPDA group was signiifcantly higher than that in asPDA group, and the level of plasma NT-proBNP in asPDA group was signiifcantly higher than that in the control group (P??0.05). In the treatment group, the level of plasma NT-proBNP on the 7th day after birth was signiifcantly lower than that on the 4th day after birth (P??0.05). In PDA group, the level of plasma NT-proBNP on the 4th day after birth was positively correlated with ductus arteriosus (DA) diameter, ratio of the left atrium to aortic root diameter (LA/AO ratio) and transductal diameter-to-left pulmonary artery ratio (TDD/LPA) (r?=?0.498-0.670, respectively). The area under receiver operator characteristic (ROC) curve for prediction of sPDA by the plasma NT proBNP on the 4th day after birth was 0.969 (95%CI:0.938-1.000). When the NT-proBNP was 13964 pg/ml on the 4th day after birth, the sensitivity for diagnosis sPDA was 95%, the speciifcity was 95.4%. Conclusions The level of plasma NT-proBNP is signiifcantly higher in preterm infants with sPDA and is decreased after treatment. Plasma NT-proBNP on the 4th day after birth is a sensitive marker for predicting sPDA. Dynamic monitoring of plasma NT-proBNP has important clinical value in selection of the treatment strategy in preterm infants with PDA.
