分子生物标志物与诊断杂志

Early Predictors of Transient Tachypnea of Newborn

Abstract

Mohammed S El Farargy*, Neama A Soliman

Background: Early diagnosis of transient tachypnea of newborn (TTN) is important for early treatment and good prognosis, but it is misdiagnosed with some diseases t hat occur in neonates like neonatal sepsis.

Aim: The study aims at investigating lactate, lactate dehydrogenase(LDH) and cystatin-C (Cys-C) as markers for early diagnosis of TTN.

Patients and methods: Blood samples taken within 1 hour after birth from 40 neonates who later developed TTN and from 40 neonates who did not develop TTN as a control group. Eighty neonates who were admitted to the NICU at Tanta University Hospital with gestational age above 37 weeks during the period 12 months (from December 2011 to May 2012, were included in this study. Neonates with RD during the first 24 hours of life constituted the patient group (n=40; 28 male: 12 female) and neonates without respiratory problems constituted the control group (n=40; 20 male; 20 female), written informed consent was obtained from all parents.

Results: Babies with TTN showed significantly higher levels of lactate, lactate dehydrogenase activity (LDH) and cystatin-C (Cys-C) level (P<0.05) in their serum than babies without TTN who act as a control group.When using the value of 2.2 pg/ml for serum lactate as a cutoff value the sensitivity was 92%, the specificity was 85%, the +PV% was 87% and the -PV% was 81% and the accuracy was 88. When using the value of 920 IU/L for serum LDH as a cutoff value the sensitivity was 94%, the specificity was 87%, the +PV% was 89% and the -PV% was 82% and the accuracy was 90. When using the value of 1.73 mg/ L for Cyst-C as a cutoff value the sensitivity was 96%, the specificity was 90%, the +PV% was 94% and the -PV% was 87% and the accuracy was 92%.

Conclusion: Serum lactate level, LDH activity and Cys-C level increased in babies with TTN if compared with babies without TTN. Hence lactate,LDH and Cys-C can be used for early diagnosis of TTN and early treatment with better prognosis.