PDF(Pubmed)
Abstract：
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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
背景：新的证据表明，N末端B型利钠肽原（NT-proBNP）在成人和儿童人群的多种心脏和肺部异常中的临床应用。迄今为止,然而,关于其对早产儿支气管肺发育不良的预测和严重程度的疗效尚无共识。本荟萃分析的目的是确定发生BPD或死于BPD的新生儿中NT-proBNP的差异，并评估该方法的诊断准确性是否有相关信息。
方法：我们根据PRISMA指南进行了系统的搜索，并研究了Medline（1966-2023），Scopus（2004-2023），Clinicaltrials.gov（2008-2023），EMBASE（1980-2023），Cochrane中央对照试验登记册CENTRAL（1999-2022）和GoogleScholar（2004-2023）以及纳入研究的参考清单。使用QUADAS-2工具评估我们研究中遇到的潜在偏倚风险。最后,共有9项研究符合资格标准，包括1319名新生儿，其中397例发生BPD,922例未受影响的对照.
结果：从我们的荟萃分析中获得的结果显示，与健康新生儿相比，患有BPD的新生儿出生后NT-proBNP水平明显升高（SMD2.57，95％CI0.41，4.72）。AUC荟萃分析的汇总效果显示，NT-proBNP在检测有严重BPD或死于该疾病的风险的新生儿方面非常准确（AUC-0.16，95％CI-0.23，-0.08）。没有研究报告与诊断BPD的方法的敏感性和/或特异性相关的数据。
结论：血清NT-proBNP水平代表了一个潜在的未来生物标志物，对于预测BPD并发早产具有很大的诊断有效性。所包括的有限数量的研究以及截止值和测量时机的显著变化仍然限制了NT-proBNP作为BPD的已建立的临床生物标志物的应用。大型前瞻性研究的设计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。
方法：我们根据PRISMA指南进行了系统的搜索，并研究了Medline（1966-2023），Scopus（2004-2023），Clinicaltrials.gov（2008-2023），EMBASE（1980-2023），Cochrane中央对照试验登记册CENTRAL（1999-2022）和GoogleScholar（2004-2023）以及纳入研究的参考清单。使用QUADAS-2工具评估我们研究中遇到的潜在偏倚风险。最后,共有9项研究符合资格标准，包括1319名新生儿，其中397例发生BPD,922例未受影响的对照.
结果：从我们的荟萃分析中获得的结果显示，与健康新生儿相比，患有BPD的新生儿出生后NT-proBNP水平明显升高（SMD2.57，95％CI0.41，4.72）。AUC荟萃分析的汇总效果显示，NT-proBNP在检测有严重BPD或死于该疾病的风险的新生儿方面非常准确（AUC-0.16，95％CI-0.23，-0.08）。没有研究报告与诊断BPD的方法的敏感性和/或特异性相关的数据。
结论：血清NT-proBNP水平代表了一个潜在的未来生物标志物，对于预测BPD并发早产具有很大的诊断有效性。所包括的有限数量的研究以及截止值和测量时机的显著变化仍然限制了NT-proBNP作为BPD的已建立的临床生物标志物的应用。大型前瞻性研究的设计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。
