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Abstract：
Objectives: To determine the efficacy of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in predicting critical pulmonary stenosis (CPS) in neonates. Methods: All neonates with pulmonary stenosis (PS) admitted to the neonatal intensive care unit of Xinhua Hospital from October 2014 to December 2020 were retrospectively reviewed. Infants with serum NT-proBNP levels measured within 48 h after birth were enrolled and divided into CPS and non-CPS groups. Serum NT-proBNP levels and cardiac Doppler indices were compared between the two groups. Correlations were determined using the Spearman\'s rank correlation coefficient. Receiver operator characteristic curve analysis was used to explore the predictive value of NT-proBNP for identifying neonatal CPS. Results: Among 96 infants diagnosed with PS by echocardiography, 46 were enrolled (21 and 25 in the non-CPS and CPS groups, respectively). Serum NT-proBNP levels were significantly higher in the CPS group than in the non-CPS group [3,600 (2,040-8,251) vs. 1,280 (953-2,386) pg/ml, P = 0.003]. Spearman\'s analysis suggested a positive correlation between Ln(NT-proBNP) levels and the transvalvular pulmonary gradient (r = 0.311, P = 0.038), as well as between Ln(NT-proBNP) levels and pulmonary artery velocity (r = 0.308, P = 0.040). Receiver operating characteristic curve analysis showed that a cutoff serum NT-proBNP level of 2,395 pg/ml yielded a 66.7 and 78.9% sensitivity and specificity for identifying CPS, respectively. The area under the curve was 0.784 (95% CI, 0.637-0.931). A positive correlation was found between Ln(NT-proBNP) and length of hospital stay (r = 0.312, P < 0.05). Conclusion: Serum NT-proBNP level was positively correlated with PS severity and could be used as a biomarker to identify CPS in neonates.
摘要：
目的:探讨血清N末端B型利钠肽原(NT-proBNP)水平对新生儿危重性肺狭窄(CPS)的预测价值。方法:回顾性分析新华医院新生儿重症监护病房2014年10月至2020年12月收治的所有肺动脉狭窄(PS)新生儿的临床资料。纳入出生后48h内测定血清NT-proBNP水平的婴儿，分为CPS组和非CPS组。比较两组患者血清NT-proBNP水平及心脏多普勒指数。使用Spearman等级相关系数确定相关性。采用受试者操作特征曲线分析探讨NT-proBNP对新生儿CPS的预测价值。结果:96例婴儿经超声心动图诊断为PS,纳入46人(非CPS和CPS组分别为21人和25人，分别)。CPS组的血清NT-proBNP水平明显高于非CPS组[3,600（2,040-8,251）与1,280（953-2,386）pg/ml，P=0.003]。Spearman分析提示Ln(NT-proBNP)水平与经瓣膜肺梯度呈正相关(r=0.311,P=0.038),Ln(NT-proBNP)水平与肺动脉流速(r=0.308,P=0.040)。受试者工作特征曲线分析表明，2,395pg/ml的截止血清NT-proBNP水平对识别CPS具有66.7％和78.9％的敏感性和特异性，分别。曲线下面积为0.784(95%CI,0.637-0.931)。Ln(NT-proBNP)与住院时间呈正相关(r=0.312,P<0.05)。结论:血清NT-proBNP水平与PS严重程度呈正相关,可作为新生儿CPS的生物标志物。
