Neonatal Intensive Care Unit, Puerta del Mar Universitary Hospital, Avenida Ana de Viya 11, 11010, Cádiz, Spain.
Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain.
Eur J Pediatr. 2022 Aug;181(8):3013-3021. doi: 10.1007/s00431-022-04491-y. Epub 2022 Jun 1.
The N-terminal end of B-type natriuretic peptide (NT-proBNP) and lung ultrasound (LUS) score have been proven to be adequate early biomarkers of bronchopulmonary dysplasia (BPD) in preterm infants. Our aim was to study if the predictive capacity of each one is increased by analyzing them together. We included infants born before 32 weeks with NT-proBNP and LUS scores on the first day of life (DOL) and on the 3rd, 7th, and 14th DOL and compared the diagnostic ability for moderate-severe BPD (msBPD) of each biomarker and in combination. We also compared them with a multivariate model of msBPD using only clinical variables. The sample size was 133 patients, and twenty-seven (20%) developed msBPD. The LUS score on the 7th DOL had better performance than NT-proBNP at the same moment: area under the receiver operating characteristic curve (AUC) 0.83 (0.75-0.89) versus 0.66 (0.56-0.75), p = 0.003, without differences in the rest of the times studied. These values did not increase when using the combination of both. A multivariate regression model that included only clinical variables (birth weight and invasive mechanical ventilation (IMV) at the 7th DOL) predicted msBPD with the same AUC as after the addition of any of these biomarkers, neither together.
The LUS score is a better predictor of msBPD on the 7th DOL than NT-proBNP in preterm infants born before 32 weeks, although they have similar diagnostic accuracy on the 1st, 3rd, and 14th DOL. Neither of them, nor together, have a better AUC for msBPD than a clinical model with birthweight and the need for IMV at the 7th DOL.
• NT-proBNP and LUS score are early predictors of moderate-severe bronchopulmonary dysplasia (msBPD).
• The combination of both NT-proBNP and LUS score does not increase the predictive ability of each separately.
B 型利钠肽（NT-proBNP）的 N 端和肺部超声（LUS）评分已被证明是早产儿支气管肺发育不良（BPD）的早期充分生物标志物。我们的目的是研究分析它们是否可以增加每个标志物的预测能力。我们纳入了在 32 周前出生的婴儿，在出生后的第 1 天（DOL）以及第 3、7 和 14 天测量 NT-proBNP 和 LUS 评分，并比较了每个生物标志物和联合标志物对中重度 BPD（msBPD）的诊断能力。我们还将它们与仅使用临床变量的 msBPD 多变量模型进行了比较。样本量为 133 例患者，其中 27 例（20%）发展为 msBPD。在第 7 天 DOL 时，LUS 评分的表现优于 NT-proBNP 同期：接受者操作特征曲线下的面积（AUC）0.83（0.75-0.89）对 0.66（0.56-0.75），p=0.003，在其余研究时间点没有差异。当使用两者结合时，这些值并没有增加。仅包含临床变量（第 7 天 DOL 时的出生体重和有创机械通气（IMV））的多变量回归模型预测 msBPD 的 AUC 与添加任何这些生物标志物后相同，两者都不相同。
在出生于 32 周前的早产儿中，与第 1、3 和 14 天 DOL 相比，LUS 评分在第 7 天 DOL 时是 msBPD 的更好预测因子，尽管在第 1 天 DOL 时它们具有相似的诊断准确性。与第 7 天 DOL 时需要 IMV 的出生体重和临床模型相比，它们都没有更好的 AUC 用于预测 msBPD。
•NT-proBNP 和 LUS 评分是中重度支气管肺发育不良（msBPD）的早期预测因子。
• 联合使用 NT-proBNP 和 LUS 评分并不能增加每个标志物的预测能力。
