Rodolaki Kalliopi, Pergialiotis Vasilios, Sapantzoglou Ioakeim, Theodora Marianna, Antsaklis Panagiotis, Pappa Kalliopi, Daskalakis Georgios, Papapanagiotou Aggeliki
1st Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 11527 Athens, Greece.
1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.
J Pers Med. 2023 Aug 23;13(9):1287. doi: 10.3390/jpm13091287.
BACKGROUND: Emerging evidence suggests the clinical utility of N terminal pro B type natriuretic peptide (NT-proBNP) in multiple cardiac and pulmonary abnormalities both in adult and pediatric populations. To date, however, there is no consensus regarding its efficacy for the prediction and severity of bronchopulmonary dysplasia in premature neonates. The objective of the present meta-analysis was to determine differences in NT-proBNP among neonates that develop BPD or die from BPD and to evaluate if there is relative information on the diagnostic accuracy of the method. METHODS: We conducted a systematic search according to the PRISMA guidelines and looked into Medline (1966-2023), Scopus (2004-2023), Clinicaltrials.gov (2008-2023), EMBASE (1980-2023), Cochrane Central Register of Controlled Trials CENTRAL (1999-2022) and Google Scholar (2004-2023) together with the reference lists from included studies. The potential risk of bias encountered in our study was evaluated using the QUADAS -2 tool. Finally, a total of 9 studies met the eligibility criteria, comprising 1319 newborns, from which 397 developed BPD and 922 were unaffected controls. RESULTS: The results retrieved from our meta-analysis showed that newborns suffering from BPD had notably elevated NT-proBNP levels after birth when compared with healthy neonates (SMD 2.57, 95% CI 0.41, 4.72). The summary effect of the AUC meta-analysis showed that NT-proBNP was very accurate in detecting neonates at risk of developing severe BPD or dying from the disease (AUC -0.16, 95% CI -0.23, -0.08). No studies reported data relevant to the sensitivity and/or specificity of the method in diagnosing BPD. CONCLUSION: Serum NT-proBNP levels represent a potential future biomarker with great diagnostic validity for the prediction of BPD complicating preterm deliveries. The limited amount of studies included and the significant variations in cutoff values and timing of measurement still restrict the application of NT-proBNP as an established clinical biomarker for BPD. The design of larger prospective studies will provide a more representative number of participants and will address the discrepancies in existing literature.
背景：新出现的证据表明，N末端B型利钠肽原（NT-proBNP）在成人和儿童的多种心脏和肺部异常情况中具有临床应用价值。然而，迄今为止，关于其在预测早产儿支气管肺发育不良（BPD）及评估病情严重程度方面的疗效尚无共识。本荟萃分析的目的是确定发生BPD或死于BPD的新生儿之间NT-proBNP的差异，并评估该方法在诊断准确性方面是否有相关信息。 方法：我们根据PRISMA指南进行了系统检索，查阅了Medline（1966 - 2023年）、Scopus（2004 - 2023年）、Clinicaltrials.gov（2008 - 2023年）、EMBASE（1980 - 2023年）、Cochrane对照试验中央注册库CENTRAL（1999 - 2022年）和谷歌学术（2004 - 2023年）以及纳入研究的参考文献列表。我们使用QUADAS - 2工具评估了研究中可能遇到的偏倚风险。最后，共有9项研究符合纳入标准，涉及1319名新生儿，其中397名发生了BPD，922名是未受影响的对照组。 结果：我们的荟萃分析结果显示，与健康新生儿相比，患BPD的新生儿出生后NT-proBNP水平显著升高（标准化均数差2.57，95%置信区间0.41，4.72）。AUC荟萃分析的汇总效应表明，NT-proBNP在检测有发生严重BPD或死于该病风险的新生儿方面非常准确（AUC - 0.16，95%置信区间 - 0.23， - 0.08）。没有研究报告该方法在诊断BPD时的敏感性和/或特异性相关数据。 结论：血清NT-proBNP水平代表了一种潜在的未来生物标志物，对预测早产相关的BPD具有很大的诊断价值。纳入研究数量有限，以及临界值和测量时间的显著差异，仍然限制了NT-proBNP作为BPD既定临床生物标志物的应用。设计更大规模的前瞻性研究将提供更具代表性的参与者数量，并解决现有文献中的差异。
Cochrane Database Syst Rev. 2022-2-1
J Perinatol. 2020-1-10
Pediatr Pulmonol. 2019-12-23
Diagnostics (Basel). 2025-2-16
J Thromb Thrombolysis. 2024-2
Zotero 插件
