Klinik für Neonatologie, Charité Universitätsmedizin Berlin, D-13344 Berlin, Germany.
Pediatrics. 2011 Sep;128(3):e545-9. doi: 10.1542/peds.2011-0603. Epub 2011 Aug 8.
The goal of this study was to evaluate urinary N-terminal fragment of B-type natriuretic peptide concentrations, normalized to creatinine (UNBCR), to predict morbidities at discharge in preterm infants.
UNBCR were determined in urine collected on day of life (DOL) 2, 7, 14, and 28 in 136 preterm infants <1500 g birth weight, 22 of whom developed bronchopulmonary dysplasia (BPD), defined as oxygen supplementation at 36 weeks' gestational age) and 11 infants developed severe retinopathy (ROP), defined as stage 3 or stage ≥ 2 requiring surgery).
UNBCR on DOL 7, 14, and 28 was elevated in infants who developed BPD or ROP compared with controls (P ≤ .001). On multiple regression analysis including birth weight and gestational age, ROP but not BPD remained independently associated with UNBCR on DOL 14 and 28. Areas under receiver operating characteristic curves for UNBCR on DOL 14 and 28 to predict ROP were 0.938 (0.027) and 0.954 (0.021), respectively. UNBCR DOL 14 and 28 thresholds exceeded by all infants with severe ROP (100% sensitivity, 100% negative predictive value) had a specificity of 66% and 85%, respectively.
UNBCR might hold promise to reduce unnecessary eye examinations by timely and accurate identification of infants at risk of severe ROP.
本研究旨在评估尿中脑钠肽 N 末端片段（UNBCR）与肌酐的比值（UNBCR），以预测早产儿出院时的并发症。
我们对 136 名出生体重<1500 克的早产儿在生后第 2、7、14 和 28 天收集尿液，检测 UNBCR。其中 22 例发生支气管肺发育不良（BPD），定义为在 36 周胎龄时需要吸氧；11 例发生严重视网膜病变（ROP），定义为需要手术治疗的 3 期或 2 期以上病变。
与对照组相比，发生 BPD 或 ROP 的早产儿在生后第 7、14 和 28 天的 UNBCR 升高（P≤0.001）。在包括出生体重和胎龄的多因素回归分析中，ROP 而不是 BPD 与 DOL 14 和 28 的 UNBCR 独立相关。预测 ROP 的 DOL 14 和 28 的 UNBCR 受试者工作特征曲线下面积分别为 0.938（0.027）和 0.954（0.021）。所有严重 ROP 患儿的 DOL 14 和 28 的 UNBCR 阈值（敏感性为 100%，阴性预测值为 100%）的特异性分别为 66%和 85%。
通过及时准确地识别有发生严重 ROP 风险的患儿，UNBCR 可能有助于减少不必要的眼部检查。
