Correlation Analysis Of Inflammation And Oxidative Stress In Preterm Infants With Bronchopulmonary Dysplasia

ObjectiveBronchopulmonary Dysplasia(BPD)is one of the most common diseases in neonatal intensive care unit(NICU)that seriously impair the prognosis and quality of life of preterm infants,and its pathogenesis is complex.It is currently believed that inflammatory response and oxidative stress are key links in the occurrence and development of BPD.This study analyzed the influencing factors of the occurrence and development of BPD,and discussed the dynamic changes of hematological indicators involved in inflammatory response and oxidative stress in the body and their correlation with BPD,so as to help clinicians diagnose and treat BPD early.MethodsThis was a retrospective study.We used the electronic medical record system to analyze 135 patients hospitalized in the NICU during January 2020 ~ January 2021 with gestational age(GA)< 32 weeks,birth weight(BW)< 1500 g.The general information of the preterm infants,including perinatal risk factors,comorbidities,treatment,and hematologic parameters on day 1,week 1,week 2,week 3,and week 4after birth,including white blood cell count,neutrophil count,lymphocyte count,eosinophil count,platelet count,serum albumin level,total serum bilirubin(TSB)level,serum uric acid level,was collected.According to the new consensus on BPD published by the National Institute of Child and Human Development(NICHD)in 2001,135 premature infants were grouped and graded.The differences between the general conditions and hematological indicators of preterm infants between the BPD group and the non-BPD group were compared,and the influencing factors of BPD development were explored.In addition,the correlation between statistically different indicators and BPD severity was analyzed,and the influencing factors of BPD exacerbation were explored.ResultsA total of 135 preterm infants were included in this study,including 73 in the non-BPD group and 62 in the BPD group.The BPD group included 37 cases of mild BPD,12 cases of moderate BPD,and 13 cases of severe BPD.(1)Comparison of general conditions: univariate analysis showed that GA,BW,cesarean section rate,1-minute and 5-minute Apgar score,resuscitation methods-endotracheal intubation and drug use and duration of mechanical ventilation were statistically different between the two groups(P <0.05);Multivariate analysis suggested that small GA(OR=0.473,95%CI: 0.308-0.727)and low BW(OR=0.997,95% CI: 0.994-1.000)were independent risk factors for the development of BPD.(2)Comparison of hematological indexes:univariate analysis showed that the white blood cell count in the 1st,2nd and 4th weeks after birth,the neutrophil count in the 1st,3rd and 4th weeks,the platelet count in the2 nd,3rd and 4th weeks,albumin in the 1st day,TSB in the 1st and 2nd weeks,and uric acid in the 1st week had significant differences between the non-BPD group and the BPD group(P <0.05);Multivariate analysis showed that neutrophil count(OR=2.118,95% CI: 1.039-4.285)at 4 weeks and uric acid(OR=1.008,95% CI: 1.000-1.016)at 1week were independent risk factors for BPD,albumin at 1 day(OR=0.810,95% CI:0.683-0.962)and TSB(OR=0.969,95%CI:0.945-0.993)at 2 weeks were independent protective factors against BPD development.Univariate analysis showed that TSB at week 2 were statistically different between groups with mild,moderate,and severe BPD(P<0.05).(3)ROC analysis was performed on the indicators with predictive value.Among clinical indicators,the predicted value of GA(AUC=0.857,95% CI:0.794-0.921)was the largest,with a sensitivity of 93.2% and a specificity of 62.9%;BW(AUC = 0.760,95% CI: 0.681 to 0.840)was 79.5% sensitive and 58.1% specific.Among the hematological indicators,TSB(AUC=0.750,95% CI: 0.664-0.836)at 2weeks had the greatest predictive value,with a sensitivity of 67.2% and a specificity of78%.The sensitivity of neutrophil count(AUC=0.671,95% CI: 0.576-0.765)at 4 weeks was 71% and specificity was 57.1%.The sensitivity of albumin at 1 day(AUC=0.04,95% CI: 0.490-0.699)was 71.2% and specificity was 62.9%.The sensitivity of uric acid(AUC=0.593,95% CI: 0.490-0.699)at 1 week was 50.7% and specificity was 64.5%.ConclusionsThis study showed that small GA and low BW were independent risk factors for the development of BPD.Of the common clinical hematologic indicators,neutrophil count,albumin,TSB,and uric acid levels may be associated with the development of BPD.In clinical work,attention should be paid to identifying high-risk factors for BPD in preterm infants and dynamically monitoring hematological indicators to help prevent and diagnose BPD early and improve the prognosis of infants.