Objective:  To study the dynamic changes of platelet parameters in preterm infants with bronchopulmonary dysplasia （BPD） and its clinical significance. Methods: From January 2015 to March 2021, preterm infants with gestational age less than 32 weeks were admitted to Affiliated Hospital of Jiangsu University， whose clinical data and platelet parameters such as platelet count, mean platelet volume, platelet distribution width and platelet mass index were retrospectively analyzed, and the clinical data and platelet parameters of each group were also compared. Logistic regression was used to analyze the relationship between platelet parameters and BPD, and receiver operating characteristic curve was used to analyze the predictive value of platelet count and platelet mass index for BPD. Results: A total of 224 premature infants, 48 with BPD and 176 with nonBPD were included. The platelet count and platelet mass index of BPD on first day were lower than those of nonBPD. After adjusting for gestational age, birth body weight, patent ductus arteriosus and the use of pulmonary surfactant, platelet mass index (OR=0.91, 95% CI: 0.850-0.945) and platelet count (OR=0.96, 95% CI: 0.924-0.986) were independent risk factors for BPD. Platelet mass index (AUC=0.766, 95% CI: 0.681~0.855, P<0.01) and platelet count (AUC=0.668, 95% CI: 0.566~0.770, P<0.01) could predict the occurrence of BPD. Conclusion: The low platelet mass index and platelet count in preterm infants may be related to the occurrence of BPD. Postnatal platelet mass index and platelet count may be used for predicting the occurrence of BPD.

Objective:To explore the key genes and signal pathways of bronchopulmonary dysplasia (BPD) using bioinformatics. Methods:  Data sets were screened in the gene expression omnibus (GEO) database, the GEO2R tool was used to screen the differentially expressed genes between BPD and extremely preterm infants without BPD. Functional annotation and pathway analysis were performed using the DAVID database, proteinprotein interaction (PPI) network construction of key DEGs was completed using the STRING online tool. The core genes were screened and visualized by Cytoscape software. Results: A total of 375 genes were up-regulated and 390 genes were downregulated via differential analysis. GO enrichment analysis showed that differentially expressed genes were involved in cellular response to calcium ions responsiveness, transcriptional regulation of RNA polymerase Ⅱ promoter, and heart development. KEGG enrichment analysis showed that differentially expressed genes were concentrated in glucagon signaling pathway and breast cancer signaling pathway. Ten core genes were identified from the constructed PPI network, namely JUN, FOS, SMARCA4, ATF3, EGR1, ERBB2, PPARA, FOSB, NR4A1 and IGF1. Conclusion:  JUN, FOS, ATF3 and EGR1 may play an important role in the pathogenesis and development of BPD.

 

近年来，肺脏超声已经成功用于新生儿肺部疾病的诊断和鉴别诊断，对早产儿支气管肺发育不良(bronchopulmonary dysplasis，BPD)预测和诊断也具有一定价值。对出生后存在呼吸困难的极早产和超早产儿，如肺部病变迟迟（如至出生2周后）不恢复则日后发展为BPD的概率显著增大。肺脏超声对早期BPD诊断较为困难，但对晚期BPD有一定诊断价值，其主要超声影像学特点包括虫蚀样胸膜线异常、肺间质综合征和囊泡充气征等。本文对此予以简介。