Jameii Khosroshahi Ahmad, Kianfar Ali, Mohammadpour Aharanjani Behzad, Sayadpour Zanjani Keyhan
Department of Pediatrics, Shaheed Madani Hospital, Tabriz University of Medical Sciences, Tabriz.
Motahhari Educational Hospital, Urmia University of Medical Sciences, Urmia.
Iran J Pediatr. 2014 Dec;24(6):766-9. Epub 2012 Dec 9.
We studied usefulness of serum B-type natriuretic peptide level as a screening tool for detecting hemodynamically significant patent ductus arteriosus in the preterm neonates.
Sixty admitted preterm neonates with gestational age ≤34 weeks, birth weight ≤2500 gr, and age of >3 days have been enrolled in this study. We measured serum B-type natriuretic peptide levels at the beginning and after completion of drug therapy for ductus occlusion.
Mean±SD gestational age and weight was 31±1.9 weeks and 1680±350 gr, respectively. The peptide levels in the neonates with significant duct (n=13) were significantly higher than in those with insignificant duct (n=17) or no duct (n=30) (1667±821 pg/ml versus 667±666 and 309±171, respectively). The peptide level dropped significantly after ibuprofen administration in the neonates with significant PDA (n=13), (1667±1165 pg/ml to 429±386).
At a cutoff point of 450 pg/ml, B-type natriuretic peptide level had a sensitivity of 92% and specificity of 87%, the negative predictive value of 98.5%, the positive likelihood ratio of 6.92 and the negative likelihood ratio of 0.089 for detecting significant patent duct. Levels below this can eliminate the need for echocardiography.
我们研究了血清B型利钠肽水平作为检测早产儿血流动力学显著动脉导管未闭筛查工具的实用性。
本研究纳入了60例胎龄≤34周、出生体重≤2500克且年龄>3天的入院早产儿。我们在开始药物封堵动脉导管治疗时和治疗结束后测量了血清B型利钠肽水平。
平均±标准差胎龄和体重分别为31±1.9周和1680±350克。有显著动脉导管未闭的新生儿（n=13）的肽水平显著高于动脉导管未闭不显著的新生儿（n=17）或无动脉导管未闭的新生儿（n=30）（分别为1667±821皮克/毫升、667±666皮克/毫升和309±171皮克/毫升）。在有显著动脉导管未闭的新生儿（n=13）中，布洛芬给药后肽水平显著下降（从1667±1165皮克/毫升降至429±386皮克/毫升）。
在截断值为450皮克/毫升时，B型利钠肽水平检测显著动脉导管未闭的灵敏度为92%，特异性为87%，阴性预测值为98.5%，阳性似然比为6.92，阴性似然比为0.089。低于此水平可无需进行超声心动图检查。
