Correlative Research Between N-terminal Pro-brain Natriuretic Peptide And Patent Ductus Arteriosus In Preterm Infants

Objective To study the correlation between N-terminal pro-brain natriuretic peptide and patent ductus arteriosus in preterm infants.Methods Preterm infants born at a gestational age between 28 and 32 weeks,including 28 and 32 weeks,with birth weight less than or equal to 1500 g and diagnosed with patent ductus arteriosus(PDA)by echocardiography within 72 hours after birth who were admitted to the neonatal intensive care unit from May 2016 to January 2017 were recruited.Their clinical manifestations were observed,and serum N-terminal pro-brain natriuretic peptide(NT-proBNP)levels were measured and echocardiography was performed on 3th and 6th days after birth.These infants were divided into PDA group(n=29)and non-PDA group(n=63)based on the results of echocardiography on the 3th day.According to the diagnostic criteria of symptomatic PDA,the PDA group was classified into the s PDA group(s PDA,n=18)and the asymptomatic PDA group(as PDA,n=11).The correlations between serum NT-proBNP level and echocardiographic indices were analyzed.Serum NT-proBNP levels were compared among the three groups.The receiver operator characteristic(ROC)curve was applied to determine the sensitivity and specificity of serum NT-proBNP level in the prediction of s PDA.Results On the 3th and 6th day after birth,the serum NT-proBNP level in the s PDA group was significantly highest than that in non-PDA and as PDA groups(P<0.001).And the serum NT-proBNP level in as PDA group was significantly higher than that in the non-PDA group(P=0.003)on the 3th day after birth,while on the 6th day after birth,there was no statistical significance of the serum NT-proBNP level between as PDA and non-PDA groups.In the treatment group,the serum NT-proBNP level on the 6th day after birth was significantly lower than that on the 3th day after birth(P<0.001).But in the non-treatment group,there was no significant difference of the serum NT-proBNP level between the 3th day and the 6th day after birth(P=0.180).Although there was no significant difference of the serum NT-proBNP level between the non-treatment and treatment groups on the 3th day(P=0.392),the serum NT-proBNP level of treatment group on the 6th day after birth was significantly lower than that on the 6th day after birth(P=0.013)between the two groups.In PDA group,the serum NT-proBNP level on the 3th day after birth was positively correlated with ductus arteriosus diameter(r=0.678,P<0.001),however,there was no significant difference between the serum NT-proBNP level and left ventricular ejection fraction(LVEF)(r=-0.022,P=0.832).The area under receiver operator characteristic(ROC)curve for prediction of s PDA by the serum NT-proBNP level on the 3th day after birth was 0.961(95%CI: 0.919~1.000).When the NT-proBNP level was 6573.2 pg/ml on the 3th day after birth,the sensitivity for diagnosis s PDA was 88.9%,and the specificity was 94.6%.Conclusions The serum NT-proBNP level is significantly higher in preterm infants with s PDA and decreases after treatment.Monitoring serum NT-proBNP level on the3 th day after birth has an important clinical value in selection of the treatment strategy in preterm infants with s PDA.