2025 年第 3 期 第 20 卷

血清B型脑钠肽和铁蛋白及胰岛素样生长因子1水平与早产儿支气管肺发育不良的关系

Relationship between serum brain natriuretic peptide, ferritin and insulin-like growth factor 1 levels and bronchopulmonary dysplasia in premature infants

作者：梁俊霞王玲玲朱雷刘小婧许津莉

英文作者：Liang Junxia Wang Lingling Zhu Lei Liu Xiaojing Xu Jinli

单位：河北北方学院附属第一医院新生儿科，张家口075000

英文单位：Department of Neonatology the First Affiliated Hospital of Hebei North University Zhangjiakou 075000 China

关键词：支气管肺发育不良；早产儿；B型脑钠肽；铁蛋白；胰岛素样生长因子1

英文关键词：Bronchopulmonarydysplasia;Prematureinfant;Brainnatriureticpeptide;Ferritin;Insulin-likegrowthfactor-1

• 摘要：

• 目的 探讨血清B型脑钠肽（BNP）、铁蛋白、胰岛素样生长因子1（IGF-1）水平与早产儿支气管肺发育不良（BPD）之间的相关性，以期为BPD的诊断提供科学依据。方法 选取2021年5月至2023年5月河北北方学院附属第一医院收治的80例早产儿，根据早产儿出生后28 d是否发生BPD分为BPD组（38例）和非BPD组（42例）。BPD组患儿根据病情程度分为轻度组（14例）、中度组（13例）和重度组（11例）。分别采集研究对象的血液样本，并收集其基本临床信息。采用酶联免疫吸附试验法检测血清BNP、铁蛋白、IGF-1水平，比较BPD组和非BPD组之间及BPD不同严重程度亚组之间的差异。采用Logistic回归方法分析早产儿BPD发生的危险因素。结果 BPD组血清BNP、铁蛋白水平高于非BPD组［（1 429±408）ng/L比（137±33）ng/L、（372±120）μg/L比（160±50）μg/L］，IGF-1水平低于非BPD组［（26±8）μg/L比（37±12）μg/L］，差异均有统计学意义（均P＜0.05）。BPD早产儿血清BNP、铁蛋白水平随病情严重程度而升高，轻度组＜中度组＜重度组；IGF-1水平则随病情严重程度而下降，轻度组＞中度组＞重度组，两两比较差异均有统计学意义（均P＜0.05）。BPD组机械通气时间、住院时间、持续气道正压通气时间和新生儿肺炎、新生儿窒息比例均高于非BPD组，差异均有统计学意义（均P＜0.05）。Logistic回归分析结果显示，血清BNP、铁蛋白水平、机械通气时间、持续气道正压通气时间均为早产儿BPD的危险因素，而IGF-1水平为其保护因素（均P＜0.05）。结论 BPD早产儿血清BNP、铁蛋白水平升高，IGF-1水平降低，三者可以作为BPD的病情判断指标，对评估早产儿BPD病情具有重要意义。

• Objective  To investigate the relationship between serum brain natriuretic peptide (BNP), ferritin and insulin-like growth factor-1 (IGF-1) levels and bronchopulmonary dysplasia (BPD) in preterm infants, in order to provide a scientific basis for the diagnosis of BPD. Methods A total of 80 premature infants admitted to the First Affiliated Hospital of Hebei North University from May 2021 to May 2023 were selected. According to the presence or absence of BPD within 28 days after birth, the preterm infants were divided into BPD group (38 cases) and non-BPD group (42 cases). According to the severity of BPD, the infants in the BPD group were divided into mild group (14 cases), moderate group (13 cases), and severe group (11 cases). Blood samples were collected from each subject, and their basic clinical information was collected. Serum levels of BNP, ferritin and IGF-1 were measured by enzyme-linked immunosorbent assay. The differences between BPD group and non-BPD group and between different severity subgroups of BPD were compared. Logistic regression was used to analyze the risk factors for BPD in preterm infants. Results The levels of serum BNP and ferritin in BPD group were higher than those in non-BPD group ［（1 429±408）mg/L vs （137±33）mg/L, （372±120）μg/L vs （160±50）μg/L］, and the level of IGF-1 was lower than that in non-BPD group ［（26±8）μg/L vs （37±12）μg/L］(all P＜0.05). The serum levels of BNP and ferritin in preterm infants with different severity of BPD rised with the severity of the disease, with mild group < moderate group < severe group; the level of IGF-1 reduced with the severity of the disease, with mild group > moderate group>severe group, and the differences between any two groups were statistically significant (all P＜0.05). The duration of mechanical ventilation, length of hospital stay, duration of continuous positive airway pressure, and the proportion of neonatal pneumonia and neonatal asphyxia in BPD group were higher than those in non-BPD group (all P＜0.05). Logistic regression analysis showed that serum levels of BNP and ferritin, duration of mechanical ventilation, and duration of continuous positive airway pressure were risk factors for BPD in preterm infants, while IGF-1 level was a protective factor (all P＜0.05). Conclusions  The levels of serum BNP and ferritin in preterm infants with BPD are increased, and the level of IGF-1 is decreased. The three levels can be used as indicators of BPD, which are of great significance in evaluating the condition of preterm infants with BPD.