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Abstract：
BACKGROUND: To examine the value of early echocardiographic indices for the right ventricular function combined with platelet(PLT) parameters for predicting bronchopulmonary dysplasia (BPD) in preterm infants.
METHODS: This retrospective study included infants with gestational age (GA) below 32 weeks, who were admitted to the neonatal intensive care unit(NICU). The detection rate of tricuspid regurgitation jet velocity (TRVJ), ventricular septal flattening, pulmonary artery widening, right ventricular dilation, and right atrial enlargement on the 7th day of life (DOL 7) were compared between BPD and non-BPD infants. Echocardiographic indices of the right ventricular function including tricuspid annular plane systolic excursion (TAPSE) and right ventricular index of myocardial performance (RIMP) were measured on 1 day of life (DOL 1)、on DOL 7 and on 14 day of life (DOL 14) respectively. The PLT parameters including the PLT count, mean platelet volume (MPV), platelet hematocrit (PCT) level, and platelet distribution width (PDW) were measured on the DOL 1,DOL 7, and DOL 14. Multivariate logistic regression was used to analyze the relationship between these parameters and BPD. Receiver operating characteristic curve analysis was performed to assess the predictive value of the right ventricular function indices and PLT parameters for BPD.
RESULTS: A total of 220 preterm infants were included in this study, and of these, 85 infants developed BPD among them. The RIMP of the BPD group on DOL 14 was higher than that of the non-BPD group (P < 0.05). The TAPSE of the BPD group on DOL 14 was lower than that of the non-BPD group (P < 0.05). The PLT count of the BPD group on DOL 1 was lower than that of the non-BPD group (P < 0.05), and the MPV of the BPD group on DOL 1 was higher than that of the non-BPD group (P < 0.05). Using multivariate logistic regression, GA、invasive mechanical ventilation duration ≥ 7 days、 PLT、 MPV、 TAPSE and RIMP were found to be independent risk factors for BPD. The area under the receiver operating characteristic curve was 0.846 (95CI: 0.794∼0.899), which improved when using right ventricular function indices combined with platelet parameters.
CONCLUSIONS: TAPSE and RIMP combined with PLT count and MPV can help identify preterm infants at an increased risk of developing BPD.
METHODS: This retrospective study included infants with gestational age (GA) below 32 weeks, who were admitted to the neonatal intensive care unit(NICU). The detection rate of tricuspid regurgitation jet velocity (TRVJ), ventricular septal flattening, pulmonary artery widening, right ventricular dilation, and right atrial enlargement on the 7th day of life (DOL 7) were compared between BPD and non-BPD infants. Echocardiographic indices of the right ventricular function including tricuspid annular plane systolic excursion (TAPSE) and right ventricular index of myocardial performance (RIMP) were measured on 1 day of life (DOL 1)、on DOL 7 and on 14 day of life (DOL 14) respectively. The PLT parameters including the PLT count, mean platelet volume (MPV), platelet hematocrit (PCT) level, and platelet distribution width (PDW) were measured on the DOL 1,DOL 7, and DOL 14. Multivariate logistic regression was used to analyze the relationship between these parameters and BPD. Receiver operating characteristic curve analysis was performed to assess the predictive value of the right ventricular function indices and PLT parameters for BPD.
RESULTS: A total of 220 preterm infants were included in this study, and of these, 85 infants developed BPD among them. The RIMP of the BPD group on DOL 14 was higher than that of the non-BPD group (P < 0.05). The TAPSE of the BPD group on DOL 14 was lower than that of the non-BPD group (P < 0.05). The PLT count of the BPD group on DOL 1 was lower than that of the non-BPD group (P < 0.05), and the MPV of the BPD group on DOL 1 was higher than that of the non-BPD group (P < 0.05). Using multivariate logistic regression, GA、invasive mechanical ventilation duration ≥ 7 days、 PLT、 MPV、 TAPSE and RIMP were found to be independent risk factors for BPD. The area under the receiver operating characteristic curve was 0.846 (95CI: 0.794∼0.899), which improved when using right ventricular function indices combined with platelet parameters.
CONCLUSIONS: TAPSE and RIMP combined with PLT count and MPV can help identify preterm infants at an increased risk of developing BPD.
摘要：
背景：探讨早期超声心动图指标联合血小板（PLT）参数对早产儿支气管肺发育不良（BPD）的预测价值。
方法：这项回顾性研究包括胎龄（GA）低于32周的婴儿，入住新生儿重症监护病房（NICU）。三尖瓣反流射流速度（TRVJ）的检出率，室间隔变平,肺动脉增宽,右心室扩张,比较了BPD和非BPD婴儿在生命第7天（DOL7）的右心房扩大。分别在生命第1天（DOL1），DOL7和生命第14天（DOL14）测量右心室功能的超声心动图指标，包括三尖瓣环平面收缩偏移（TAPSE）和右心室心肌性能指数（RIMP）。PLT参数包括PLT计数，平均血小板体积（MPV），血小板血细胞比容（PCT）水平，在DOL1、DOL7和DOL14上测量血小板分布宽度(PDW)。采用多因素logistic回归分析这些参数与BPD的关系。进行受试者工作特征曲线分析以评估右心室功能指标和PLT参数对BPD的预测价值。
结果：本研究共纳入220名早产儿，其中，其中85名婴儿发展为BPD。BPD组对DOL14的RIMP高于非BPD组(P<0.05)。BPD组对DOL14的TAPSE低于非BPD组（P<0.05）。BPD组对DOL1的PLT计数低于非BPD组（P<0.05），BPD组对DOL1的MPV高于非BPD组（P<0.05）。使用多元逻辑回归，GA、有创机械通气时间≥7天、PLT、MPV、TAPSE和RIMP是BPD的独立危险因素。受试者工作特征曲线下面积为0.846(95CI:0.794~0.899)，当使用右心室功能指数结合血小板参数时，改善。
结论：TAPSE和RIMP结合PLT计数和MPV可以帮助识别发生BPD风险增加的早产儿。
方法：这项回顾性研究包括胎龄（GA）低于32周的婴儿，入住新生儿重症监护病房（NICU）。三尖瓣反流射流速度（TRVJ）的检出率，室间隔变平,肺动脉增宽,右心室扩张,比较了BPD和非BPD婴儿在生命第7天（DOL7）的右心房扩大。分别在生命第1天（DOL1），DOL7和生命第14天（DOL14）测量右心室功能的超声心动图指标，包括三尖瓣环平面收缩偏移（TAPSE）和右心室心肌性能指数（RIMP）。PLT参数包括PLT计数，平均血小板体积（MPV），血小板血细胞比容（PCT）水平，在DOL1、DOL7和DOL14上测量血小板分布宽度(PDW)。采用多因素logistic回归分析这些参数与BPD的关系。进行受试者工作特征曲线分析以评估右心室功能指标和PLT参数对BPD的预测价值。
结果：本研究共纳入220名早产儿，其中，其中85名婴儿发展为BPD。BPD组对DOL14的RIMP高于非BPD组(P<0.05)。BPD组对DOL14的TAPSE低于非BPD组（P<0.05）。BPD组对DOL1的PLT计数低于非BPD组（P<0.05），BPD组对DOL1的MPV高于非BPD组（P<0.05）。使用多元逻辑回归，GA、有创机械通气时间≥7天、PLT、MPV、TAPSE和RIMP是BPD的独立危险因素。受试者工作特征曲线下面积为0.846(95CI:0.794~0.899)，当使用右心室功能指数结合血小板参数时，改善。
结论：TAPSE和RIMP结合PLT计数和MPV可以帮助识别发生BPD风险增加的早产儿。
