Significance of plasma β-catenin, transforming growth factor-β1, Clara cell secretion protein,Krebs von den Lungen-6 level changes of bronchopulmonary dysplasia premature children after birth and in different mechanical ventilation period

Abstract

Objective To dynamically monitor the changes of plasma β-catenin,transforming growth factor-β 1(TGF-β 1),Clara cell secretion protein(CC16),Krebs yon den Lungen-6 (KL-6) level of bronchopulmonary dysplasia (BPD) premature children after birth and in different mechanical ventilation period,so as to discuss the function in ventilator-induced lung injury and explore the risk factors of BPD.Methods Ninety premature children were divided into non-mechanical ventilation group,non-BPD mechanical ventilation group,BPD mechanical ventilation group and 30 cases in each group.Besides,another 40 normal term infants to make comparison were selected as control group.The levels of plasma β-catenin,KL-6,CC 16,TGF-β 1 were measured by enzyme-linked immunosorbent assay before mechanical ventilation and 1,24,48,72 h after mechanical ventilation and 24 h after weaning.Results Gestational age and birth weight decreased in control group,non-mechanical ventilation group,non-BPD mechanical ventilation group,BPD mechanical ventilation group [(40.50 ± 1.46),(33.07 ± 2.42),(31.67 ± 2.73),(29.80 ± 1.71) weeks and (3 184.33 ± 548.99),(1 752.33 ±255.81),(1 433.00 ± 177.30),(1 254.50 ± 117.78) g],pairwisecomparisons were statistically significant differences (P ＜0.05).The time of mechanical ventilation andoxygen inhalation in BPD mechanical ventilation group was longer than that in non-BPD mechanical ventilation group [(15.23 ± 4.28) d vs.(3.53 ± 1.01) d and (45.57 ± 7.89) d vs.(18.57 ± 3.93) d],and there was significant difference (P ＜ 0.05).The level of plasma β-catenin,TGF-β1 was increased and the level of plasma CC 16 was decreased in control group,non-mechanical ventilation group,non-BPD mechanical ventilation group,BPD mechanical ventilation group,pairwise comparisons were statistically significant differences (P ＜ 0.05).There was no significant difference in the level of plasma KL-6 among four groups (P ＞ 0.05).The level of plasma KL-6,CC 16,TGF-β1,β-catenin in BPD mechanical ventilation group at mostly period was worse than that in non-BPD mechanical ventilation group.In BPD mechanical ventilation group,the level of plasma β-eatenin directly correlated with TGF-β 1,KL-6 (r =0.374 and 0.418,P ＜ 0.01).Multi-factor stepwise regression analysis indicated that the lower birth weight,longer mechanical ventilation,higher β-catenin,TGF-β 1 after birth,lower CC16 level were the risk factor of BPD(P＜ 0.01 or ＜ 0.05).Conlusions Higher plasma β-catenin,TGF-β1 and lower CC16 after birth have close relation with BPD,the level of plasma β-catenin,KL-6,TGF-β 1 in BPD development interact as both cause and effect.Dynamic detection of plasma β-catenin,TGF-β 1,KL-6,CC16 changes of mechanical ventilation in premature children will help monitor lung injury of mechanical ventilation,for the early diagnosis of BPD,treatment,and the evaluation of prognosis have important clinical value. Key words: Bronchopulmonary dysplasia; Respiration,artificial; Transforming growth factor beta1 ; β-catenin; Krebs von den Lungen-6; Clara cell secretion protein