Department of Neonatology, Children's Hospital of Soochow University, Suzhou, China.
Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou, China.
BMC Pulm Med. 2024 Jul 28;24(1):363. doi: 10.1186/s12890-024-03145-z.
This study aimed to predict the bronchopulmonary dysplasia (BPD) in preterm infants with a gestational age(GA) < 32 weeks utilizing clinical data, serum mediator complex subunit 1 (MED1), and serum peroxisome proliferator-activated receptor gamma coactivator-1alpha (PGC-1α).
This prospective observational study enrolled 70 preterm infants with GA < 32 weeks. The infants were categorized into two groups: non-BPD group(N = 35) and BPD group(N = 35), including 25 cases with mild BPD and 10 patients with moderate/severe subgroups. We performed multifactorial regression analysis to investigate the postnatal risk factors for BPD. Furthermore, we compared serum levels of biomarkers, including MED1 and PGC-1α, among infants with and without BPD at postnatal days 1, 7, 14, 28, and PMA 36 weeks. A logistic regression model was constructed to predict BPD's likelihood using clinical risk factors and serum biomarkers.
Serum levels of MED1 on the first postnatal day, PGC-1α on the 1st, 7th, and 28th days, and PMA at 36 weeks were significantly lower in the BPD group than in the non-BPD group (P < 0.05). Furthermore, the predictive model for BPD was created by combing serum levels of MED1 and PGC-1α on postnatal day 1 along with clinical risk factors such as frequent apnea, mechanical ventilation time > 7 d, and time to reach total enteral nutrition. Our predictive model had a high predictive accuracy(C statistics of 0.989) .
MED1and PGC-1α could potentially serve as valuable biomarkers, combined with clinical factors, to aid clinicians in the early diagnosis of BPD.
本研究旨在利用临床数据、血清介质复合体 1(MED1)和过氧化物酶体增殖物激活受体γ共激活因子 1α(PGC-1α)预测胎龄(GA)<32 周的早产儿支气管肺发育不良(BPD)。
本前瞻性观察性研究纳入了 70 名 GA<32 周的早产儿。将婴儿分为两组:非 BPD 组(N=35)和 BPD 组(N=35),包括 25 例轻度 BPD 和 10 例中重度 BPD。我们进行了多因素回归分析,以探讨 BPD 的产后危险因素。此外,我们比较了出生后第 1、7、14、28 天和矫正胎龄(PMA)36 周时,有无 BPD 的婴儿的血清生物标志物(包括 MED1 和 PGC-1α)水平。采用逻辑回归模型构建了使用临床危险因素和血清生物标志物预测 BPD 可能性的模型。
BPD 组婴儿出生后第 1 天的 MED1 血清水平、第 1、7 和 28 天的 PGC-1α血清水平以及 PMA 在 36 周时均明显低于非 BPD 组(P<0.05)。此外,我们通过结合 MED1 和 PGC-1α 在出生后第 1 天的血清水平以及频繁呼吸暂停、机械通气时间>7 天和达到完全肠内营养时间等临床危险因素,构建了 BPD 的预测模型。我们的预测模型具有较高的预测准确性(C 统计量为 0.989)。
MED1 和 PGC-1α 可能是有价值的生物标志物,结合临床因素有助于临床医生早期诊断 BPD。