Huang Lie, Guo Ning, Cheng Meile, Wang Jianhui, Chen Feifan, Shi Yuan
Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Department of Neonatology, The First People's Hospital of Yinchuan, Ningxia Medical University, Yinchuan, China.
Front Pediatr. 2022 Oct 11;10:1013537. doi: 10.3389/fped.2022.1013537. eCollection 2022.
To explore the diagnostic value of IGF-1 and IL-18 in premature infants with BPD.
Through a prospective observational study, the serum samples of infants in the BPD group and the non-BPD group were collected at different targeted time points, and the serum IGF-1 and IL-18 concentrations were dynamically monitored by ELISA. The Student -test and one-way analysis of variance were adopted to analyze data, and the receiver operating characteristic (ROC) curve was used to test the diagnostic value.
A total of 90 VLBW premature infants admitted to NICU between January 2020 and 2021 were finally included. Compared with the non-BPD group, infants diagnosed with BPD had a significantly lower serum concentration of IGF-1 ( < 0.05) but a higher level of IL-18 ( < 0.05) on days 1, 7, 14, and 28 after birth. With the ROC curve analysis, the serum concentration IGF-1 on day 14 and IL-18 on day 28 reported high sensitivity and specificity to predict the risk of BPD (IGF-1: sensitivity: 89.29%, specificity: 77.78%, AUC: 0.8710; IL-18: sensitivity: 53.57%, specificity: 83.33%, AUC: 0.7887). And more substantial predictive power was found in combined analysis of IGF-1 and serum IL-18 on day 14: the sensitivity was 91.07% and the specificity was 83.33%, with the AUC of 0.9142.
IGF-1 and IL-18 might be closely involved in the occurrence and development of BPD. The serum concentration of IGF-1 combined with IL-18 could be potentially sensitive markers for the early diagnosis and severity of BPD.
探讨胰岛素样生长因子-1（IGF-1）和白细胞介素-18（IL-18）在支气管肺发育不良（BPD）早产儿中的诊断价值。
通过前瞻性观察研究，在不同目标时间点收集BPD组和非BPD组婴儿的血清样本，采用酶联免疫吸附测定（ELISA）法动态监测血清IGF-1和IL-18浓度。采用学生t检验和单因素方差分析进行数据分析，并用受试者工作特征（ROC）曲线检验诊断价值。
最终纳入2020年1月至2021年期间入住新生儿重症监护病房（NICU）的90例极低出生体重早产儿。与非BPD组相比，确诊为BPD的婴儿在出生后第1、7、14和28天的血清IGF-1浓度显著降低（P<0.05），但IL-18水平较高（P<0.05）。通过ROC曲线分析，出生后第14天的血清IGF-1浓度和第28天的IL-18浓度对预测BPD风险具有较高的敏感性和特异性（IGF-1：敏感性：89.29%，特异性：77.78%，曲线下面积[AUC]：0.8710；IL-18：敏感性：53.57%，特异性：83.33%，AUC：0.7887）。并且在出生后第14天IGF-1和血清IL-18的联合分析中发现了更强的预测能力：敏感性为91.07%，特异性为83.33%，AUC为0.9142。
IGF-1和IL-18可能密切参与BPD的发生和发展。血清IGF-1浓度与IL-18联合检测可能是BPD早期诊断及病情严重程度潜在的敏感标志物。
