Value Of Tenascin-C In Predicting Bronchopulmonary Dysplasia In Preterm Infants

Objective:To study the values of serum tenascin-C(TNC)in predicting the sensitivity to bronchopulmonary dysplasia(BPD)in premature infants.Methods: A retrospective analysis was conducted.90 premature infants hospitalized in the First Affiliated Hospital of Wannan Medical College,from October 2021 to September 2022 were divided into BPD group(n = 21)and non-BPD group(n = 69)according to BPD diagnostic criteria.The clinical data of the two groups(gestational age,body weight,sex,mode of delivery,Apgar score,maternal pregnancy and treatment,etc.)were collected.At the same time,the serum TNC level was detected by enzyme-linked immunosorbent assay(enzyme linked immunosorbent assay,ELISA)on the 1st,14 th and 28 th day after birth,and the independent predictive factors of BPD in premature infants were determined by Logistic regression.The best cut-off value and predictive value of TNC in predicting BPD in premature infants were determined by ROC curve.Results: 1.Comparison of general data between the two groups: There were statistical differences in the general information of birth weight,Apgar 5min score and gestational age between the two groups(P < 0.05),as well as in the prevalence of pulmonary hypertension,sepsis,necrotizing enterocolitis(NEC)and patent ductus arteriosus(PDA)(P < 0.05).The application rates of Pulmonary surfactant,invasive mechanical ventilation,antibiotics/fat milk/caffeine showed statistical differences(P < 0.05).There was no statistical significance in gender,delivery mode,Apgar 1min score,twins or assisted reproduction between the two groups(P > 0.05),and there was no statistical significance in the prevalence of pneumonia and intraventricular hemorrhage(P >0.05).2.Changes in serum TNC values between the two groups : There was no significant difference in the serum TNC content of the non-BPD group at the 1st day,the 2nd week and the 4th week after birth(P > 0.05),while the serum TNC content of the BPD group at the 1st day,the 2nd week and the 4th week after birth showed a gradual increasing trend,and the serum TNC level at the 4th week after birth was higher than that at the 1st day after birth(P < 0.05).After pin-wise comparison of serum TNC content on day 1,week 2 and week 4,there was no significant difference between the two groups on day 1 and week 4(P > 0.05).However,at the 2nd week,the serum TNC level in the BPD group was higher than that in the non-BPD group,and the difference between the two groups was statistically significant(P<0.05).3.In this study,it was found that serum TNC at 14 days had the most significant changes.Therefore,the relevant risk factors 14 days before were analyzed by single risk factor logistic regression.Gestational age,body weight,TNC-14 d,Apgar score,days of invasive ventilation,antibiotics,fat milk,days of caffeine use,pulmonary hypertension,sepsis,PDA and NEC were statistically significant.Multivariate logistic regression analysis of these risk factors showed that small gestational age was a risk factor for BPD.4.The value of serum TNC level and combined risk factors in diagnosing BPD at small gestational age:The ROC curve of serum TNC was plotted with 1-specificity as horizontal coordinate and sensitivity as vertical coordinate.As the above studies showed statistically significant differences between the two groups at 14 d,the area under ROC curve of serum TNC level at 14 d was 0.727,the sensitivity was 0.909,the specificity was 0.551,the Yoden index was 0.460,the 95%CI was 0.604-0.851,and the critical value was 20.1391.The area under ROC curve of fetal age combined with serum TNC level at 14 days was 0.962,sensitivity was 0.727,specificity was 0.986,95%CI was0.907-1.000.Conclusion:1.Serum TNC level is closely associated with bronchopulmonary dysplasia in premature infants,and the serum TNC level in children with bronchopulmonary dysplasia is higher than the normal level.With the continuous improvement of bronchopulmonary development of preterm infants,serum TNC level also decreased.2.Serum TNC level at 14 days after birth may be a good predictor of bronchopulmonary development in premature infants.Combined with gestational age as a high risk factor,it may be of good clinical value for early diagnosis of premature infants with bronchopulmonary dysplasia.