Effect and clinical significance of bronchopulmonary dysplasia treated by dexamethasone on N-terminal pro-brain natriuretic peptide level

Abstract

Objective To evaluate the level of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) in preterm infants with bronchopulmonary dysplasia (BPD) after dexamethasone administration and its correlation with the occurrence and severity of BPD. Method The preterm infants in NICU from December 2014 to October 2016 were enrolled in this prospective study. All of the infants were less than 32 weeks′gestational age (GA) and less than 1 500 g birth weight (BW) and they all underwent mechanical ventilation for severe (stage Ⅲ-Ⅳ) respiratory distress syndrome (RDS). The infants were assigned to weaning group and non-weaning group according to whether they underwent mechanical ventilation after 14 days of birth. Then the non-weaning group were assigned into the therapy group and control group according to whether treated by dexamethasone. By 14 and 28 days after birth, immunochromatography assay was used to detect the serum NT-proBNP respectively and the results were compared among the groups. Result A total of 157 preterm infants with severe RDS were included, 108 in the weaning group, the remaining 49 in the non-weaning group. (1)Compared with the non-weaning group, the weaning group had higher birth weight and lower plasma NT-proBNP level on day 14 (P<0.05). (2)On day 28, all of the 30 infants in the dexamethasone treated group showed significantly lower plasma NT-proBNP level than the 19 infants in the control group [(2.42±0.47) pg/ml vs.(2.90±0.44) pg/ml](P<0.05). (3)Both of the occurrence of moderate to severe BPD and the plasma NT-pro BNP level on day 28 in the dexamethasone treated group were lower than that in the non-treated group (3/30 vs.8/19) and [(2.72±0.51) pg/ml vs.(3.09±0.30) pg/ml](P<0.05). The plasma NT-proBNP level in the infants with BPD was higher than that in the infants without it and the difference was statistically significant(P<0.05). Conclusion Dexamethasone could reduce the incidence of BPD and the level of plasma NT-proBNP in infants with severe RDS. The plasma NT-pro BNP level was associated with the occurrence and severity of BPD, thus dynamic monitoring its change could be beneficial. Key words: Dexamethasone; Bronchopulmonary dysplasia; N-terminal pro-brain natriuretic peptide; Respiratory distress syndrome, newborn; Infant, premature