Journal of Clinical Pediatrics

Nutritional management in acute illness of children with inborn errors of metabolism

QIU Wenjuan, DU Taozi, XIA Yu

Journal of Clinical Pediatrics. 2023, 41(6): 401-405. doi:10.12372/jcp.2023.23e0366

Abstract ( 160 )

HTML ( 15 )

PDF (1229KB) ( 180 )

Figures and Tables | References | Related Articles | Metrics

Inborn errors of metabolism (IEMs) are a group of monogenic diseases caused by defects in enzyme, receptor, cofactor or transporter during biochemical metabolism of amino acids, carbohydrates, organic acids, fatty acids and mitochondrial energy metabolism. The metabolic emergencies due to disorders in IEM leads to high mortality and disability rates in children. Improving nutrition management in acute illness is of great significance to the prognosis of IEM. Based on the latest guidelines and expert consensus of IEM at home and abroad, combined with clinical practice, we introduced the principles and protocols of nutrition management in the acute illness of IEM, which aims to improve the nutrition management and long-term prognosis of IEM.

Effects of stress hyperglycemia on organ function in critically ill children

WU Jie, WANG Quan

Journal of Clinical Pediatrics. 2023, 41(6): 406-410. doi:10.12372/jcp.2022.23e0258

Abstract ( 123 )

HTML ( 10 )

PDF (1165KB) ( 107 )

References | Related Articles | Metrics

Stress-induced hyperglycemia (SHG) may occur in severe children under stress. It is currently believed that the pathogenesis of SHG is related to abnormal regulation of endocrine hormones, massive release of cytokines, and insulin resistance in critical cases. Continuous elevated blood glucose levels can cause mitochondrial dysfunction, activation of inflammatory pathways, and oxidative stress. Although the association between SHG and poor prognosis has received widespread attention in recent years, strategies to strictly control blood glucose combined with intensive insulin therapy do not seem to benefit critically ill children. In general, blood glcose not exceeding 180 mg/dL （10.0 mmol/L） is appropriate. This article reviews the progress of research on the definition, pathogenesis and harm of SHG in order to improve clinicians’ understanding.

Carbohydrate metabolic emergencies in inborn errors of metabolism

XU Wei

Journal of Clinical Pediatrics. 2023, 41(6): 411-416. doi:10.12372/jcp.2022.23e0263

Abstract ( 101 )

HTML ( 10 )

PDF (1425KB) ( 89 )

Figures and Tables | References | Related Articles | Metrics

The main manifestation of carbohydrate metabolic emergencies in inborn errors of metabolism is ketotic hypoglycemia. In the case of insufficient carbohydrate intake or fasting, children may have drowsiness, encephalopathy and even sudden death, and some children are accompanied by liver failure, dyskinesia or cardiac dysfunction. The diagnosis was confirmed by DNA analysis and/or detection of enzyme activity in cultured skin fibroblasts, liver cells, white blood cells, or red blood cells. Management of hypoglycemia and metabolic acidosis, provision of ventilatory and circulatory support, treatment of infection, liver replacement therapy, and other relatively specific treatments or enzyme replacement therapy are the keys to save the life.

The clinical treatment characteristics of fulminant type 1 diabetes mellitus

LI Jiru, MA Zhushengying, QIAN Wen, QIU Huinan, XU Lili, ZHU Xiaodong

Journal of Clinical Pediatrics. 2023, 41(6): 417-423. doi:10.12372/jcp.2023.22e1428

Abstract ( 134 )

HTML ( 10 )

PDF (1299KB) ( 228 )

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the clinical diagnosis and treatment of fulminant type 1 diabetes mellitus (FT1DM) in pediatrcis. Methods The clinical data of children with newly diagnosed diabetes mellitus complicated with ketoacidosis (DKA) admitted to the pediatric intensive care unit from January 2015 to June 2022 were retrospectively analyzed. The subjects were divided into FT1DM group and typical type 1 diabetes mellitus (TT1DM) combined with DKA group, and the clinical characteristics and treatment of the two groups were compared. Results A total of 90 children (42 boys and 48 girls) with initial T1DM complicated with DKA were included, and the median age was 87.0 (39.0-125.0) months. There were 85 children in TT1DM combined with DKA group and 5 in FT1DM group. None of the enrolled children died or had acute pancreatitis. The onset time of children in FT1DM group was significantly shorter than that of TT1DM combined with DKA group, and the difference was statistically significant (P<0.05). FT1DM group had more significant dehydration, influenza-like symptoms, chest tightness, fatigue and lethargy, and the proportion of tachycardia and tachypnea was significantly higher than that of TT1DM combined with DKA group, and the difference was statistically significant (P<0.05). Compared with TT1DM combined with DKA group, FT1DM group had lower levels of serum sodium, glycosylated hemoglobin (HbAlc), fasting C-peptide, sodium×HbAlc, and lower positive proportions of anti-glutamic acid decarboxylase antibody (GADA) and protein tyrosine phosphatase antibody (IA-2A); serum potassium, fasting blood glucose, creatinine, blood glucose/HbAlc and potassium/HbAlc were higher in FT1DM group, and the differences were statistically significant (P<0.05). Compared with TT1DM combined with DKA group, the fluid resuscitation dose and total therapeutic dose of insulin in FT1DM group were higher and the time to correct ketosis was longer at 24/48 hours after admission, and the difference was statistically significant (P<0.05). Conclusions FT1DM is rare in pediatric patients with newly diagnosed diabetes mellitus, has a sudden onset of disease, has a more severe disorder of glucose metabolism, and can affect multiple systems. Children with FT1DM require longer treatment periods, more exogenous insulin injections, and fluid for resuscitation and expansion.

Correlation analyses between serum uric acid and diabetic ketoacidosis in children with initially diagnosed type 1 diabetes

LIU Fang, CAO Bingyan, WANG Shiqi, CHEN Qiong, WEI Haiyan

Journal of Clinical Pediatrics. 2023, 41(6): 424-429. doi:10.12372/jcp.2023.22e1769

Abstract ( 119 )

HTML ( 4 )

PDF (1369KB) ( 94 )

Figures and Tables | References | Related Articles | Metrics

Objective To explore the correlation between serum uric acid (SUA) and diabetic ketoacidosis (DKA) of children in initially diagnosed type 1 diabetes (T1DM). Methods The clinical data of children with T1DM admitted from March 2015 to June 2022 were retrospectively analyzed. The clinical characteristics of children between DKA group and non-DKA group were compared, and the correlation between SUA level and the occurrence of DKA in children with initially diagnosed T1DM was analyzed. Results A total of 358 children with T1DM (190 boys and 168 girls) were included, and the median age was 5.8 (3.0-8.9) years. There were 186 children (52.0%) in the DKA group and 172 in the non-DKA group. There were 57 children in the mild DKA group, 64 in the moderate DKA group and 65 in the severe DKA group. A total of 49 children with HUA were diagnosed, including 43 (23.1%) in the DKA group. The blood glucose, SUA level and the proportion of co-infection on admission in the DKA group were higher than those in the non-DKA group, and the C-peptide and glomerular filtration rate in the DKA group were lower than those in the non-DKA group, and the differences were statistically significant (all P<0.05). The receiver operating characteristic (ROC) curve showed that the area under the ROC curve of SUA predicting the DKA occurrence in children with initially diagnosed T1DM was 0.94 (95%CI: 0.91-0.97). When SUA≥294.2 μmol/L, the sensitivity and specificity predicting the DKA occurrence were 92.5% and 89.0%, respectively. Spearman rank correlation analysis showed that the SUA level was negatively correlated with the valueslevels of pH and HCO^-₃ in children with initially diagnosed T1DM (P<0.01). There were statistically significant differences in SUA levels between non-DKA group and DKA groups with different degrees (P<0.01). Pairwise comparison showed that SUA levels in mild, moderate and severe DKA groups were higher than those in non-DKA group, with statistical significance (P<0.05). Conclusions The determination of SUA level has certain clinical significance in assisting the assessment of whether the initial T1DM is combined with DKA, which is conducive to the disease assessment and can be carried out in grass-roots hospitals.

Association of coefficient of glycemic variation and SNAPPE-Ⅱ with prognosis in critically ill neonates

XIANG Chao, ZHANG Rong, KANG Lan, LEI Xiaoping, LIU Xingqing, DONG Wenbin

Journal of Clinical Pediatrics. 2023, 41(6): 430-435. doi:10.12372/jcp.2023.22e0086

Abstract ( 121 )

HTML ( 6 )

PDF (1382KB) ( 69 )

Figures and Tables | References | Related Articles | Metrics

Objective To explore the association of coefficient of glycemic variation (CV) and score for neonatal acute physiology with perinatal extension-Ⅱ (SNAPPE-Ⅱ) with prognosis in critically ill neonates. Methods The clinical data of critically ill neonates admitted to the neonatal intensive care unit (NICU) from August 2018 to September 2020 were retrospectively analyzed. According to the prognosis, they were divided into death group and survival group, and the difference of clinical features between the two groups was compared. Binary logistic regression model was used to analyze the risk factors of poor prognosis in critically ill neonates. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of CV and SNAPPE-Ⅱ in poor prognosis of critically ill neonates. Results A total of 385 critically ill newborns were included, including 228 boys and 157 girls. The median age of admission was 1.0 (1.0-24.0) hours, the mean gestational age was (35.3±4.1) weeks, and the mean weight was (2456.6±860.3) grams. There were 85 hypoglycemic and 115 hyperglycemic patients. There were 80 patients in the death group, and the median time from NICU admission to death were 5.0 (2.0-10.3) days. Binary logistic regression analysis showed that CV, SNAPPE-Ⅱ, gestational age, weight, the main diagnosis of pulmonary hemorrhage and neonatal sepsis were correlated with death of critically ill neonates (P<0.05). The area under curve (AUC) of CV predicting death of critically ill neonates was 0.72, and the AUC of SNAPPE-Ⅱwas 0.85. When CV≥0.31, the sensitivity and specificity for the diagnosis of critical neonatal death were 0.75 and 0.59. When SNAPPE-Ⅱ≥18.50, the sensitivity and specificity for the diagnosis of critical neonatal death were 0.68 and 0.93. Conclusions Both CV and SNAPPE-Ⅱ have certain predictive values for the poor prognosis of critically ill neonates.

Clinical analysis of continuous blood purification in the treatment of neonatal septic shock with acute kidney injury

XU Jinglin, YANG Hansong, CHEN Xinhua, CHEN Jiangbin, LI Xiaoqing, ZHANG Weifeng, CHEN Dongmei

Journal of Clinical Pediatrics. 2023, 41(6): 436-441. doi:10.12372/jcp.2023.22e1459

Abstract ( 107 )

HTML ( 7 )

PDF (1301KB) ( 88 )

Figures and Tables | References | Related Articles | Metrics

Objective To analyze the clinical indicators of continuous blood purification (CBP) in the treatment of neonatal septic shock with acute kidney injury (AKI). Methods The clinical data of neonates with septic shock and AKI treated with CBP in the neonatal intensive care unit from January 2015 to May 2022 were retrospectively analyzed. Results Fifteen neonates with septic shock and AKI were included in this study, and eight patients died with a mortality rate of 53.3%. Among them, 10 were boys and 5 were premature infants. The age of admission was 1.0 (1.0-6.0) days, the gestational age was 38.0 (34.0-41.0) weeks, the birth weight was 3100.0 (2850.0-3250.0) grams, and the AKI stage was 2 (2-3). All children needed mechanical ventilation and vasoactive drugs. The vasoactive inotropic score (VIS) was 110.0 (64.0-320.0). The mean arterial pressure (MAP) and urine output of the CBP treatment group at 24 hours and at the end of treatment were higher than that of the pre-treatment group, and the serum creatinine and urea nitrogen were lower than that of the pre-treatment group, the difference was statistically significant (P<0.05).The commonest CBP related adverse event was thrombocytopenia (45.5%). Univariate analysis showed that no risk factors for death related to CBP were found (P>0.05). Conclusions Bedside CBP can timely maintain hemodynamic stability in neonates with septic shock and AKI, correct shock, and significantly improve the renal function. It has good security.

The application value of 5 scoring methods in the prognosis evaluation of acute respiratory distress syndrome in children

QIAO Junying, ZHANG Luodan, LI Fan, ZHAO Jianchuang, GUO Shanshan, ZHANG Jingpo

Journal of Clinical Pediatrics. 2023, 41(6): 442-449. doi:10.12372/jcp.2023.22e1197

Abstract ( 122 )

HTML ( 3 )

PDF (1264KB) ( 279 )

Figures and Tables | References | Related Articles | Metrics

Objective To explore the application value of pediatric critical illness score (PCIS), pediatric risk of mortality (PRISM) Ⅲ score, pediatric sequential organ failure assessment (pSOFA) score, radiographic assessment of lung edema (RALE) score and acute lung injury score (LIS) in the prognosis evaluation of pediatric acute respiratory distress syndrome (pARDS). Methods The clinical data of children diagnosed with ARDS admitted to the pediatric intensive care unit (PICU) from January 2015 to December 2021 were retrospectively analyzed. Results A total of 80 ARDS children with sepsis and multiple organ dysfunction were enrolled, including 45 boys and 35 girls, and the median age was 12.5 (4.0-36.3) months. There were 50 patients in the survival group and 30 patients in the death group (16 died during hospitalization and 14 died after abandonment). Compared with the survival group, the death group had higher oxygenation index (OI), higher pSOFA and PRISM Ⅲ scores at transferring to PICU and diagnosing ARDS, higher RALE and LIS scores at diagnosing ARDS, and higher proportion of vasoactive substances application and blood transfusion. Furthermore, compared with the survival group, the death group had shorter total hospital stay, PICU stay and mechanical ventilation time, and lower proportion of intrapulmonary factors, PO₂/FiO₂ and PCIS scores. The differences were statistically significant (P<0.05). Compared with the group without underlying diseases, the scores of pSOFA, PRISM Ⅲ, RALE, and LIS were higher and the scores of PCIS were lower at the diagnosis of ARDS in the group with underlying diseases, the differences were statistically significant (P<0.05). The AUCs of PCIS, pSOFA, PRISM Ⅲ, RALE, and LIS at the diagnosis of ARDS in predicting the death of ARDS children were 0.73, 0.89, 0.83, 0.80 and 0.82, respectively. Hosmer-Lemeshow goodness of fit test showed that PCIS had the best fitting effect between predicted mortality and actual mortality (χ²=4.16, P=0.656). Conclusions PCIS, pSOFA, PRISM Ⅲ, RALE and LIS scores all have good predictive ability for the prognosis of children with ARDS, and pSOFA score had the highest predictive value. PCIS had the best fitting effect between predicted mortality and actual mortality.

Clinical characteristics and genetic analysis of SETBP1 haploinsufficiency disorder

WAN Ruiping, HUANG Xiaofei, YE Xingguang, WU Yanling, DAI Jiemin, LIU Zhigang

Journal of Clinical Pediatrics. 2023, 41(6): 450-454. doi:10.12372/jcp.2023.22e1155

Abstract ( 162 )

HTML ( 12 )

PDF (1526KB) ( 93 )

Figures and Tables | References | Related Articles | Metrics

Objective To summarize the clinical phenotype and genetic variation characteristics of patients with SETBP1 haploinsufficiency disorder (SETBP1-HD). Methods The genetic variations and clinical characteristics of three children with SETBP1-HD from January 2019 to December 2021 were retrospectively analyzed. Results Three SETBP1-HD children, 1 boy and 2 girls (identical twins), were 5 years old and 5 months old respectively. All patients presented moderate intellectual disabilities, motor and language developmental retardation. Compared with the verbal expression ability, the language comprehension ability of case 1 was better, and the child also had attention deficits. Case 2 and case 3 had febrile seizures. No obvious autism-like manifestations were observed in the 3 cases, and no specific manifestations were observed on head MRI scan and video electroencephalogram. De novo heterozygous variations in SETBP1 gene were found in all patients, including a frameshift variation (c.607delG/p.Gly203Valfs*4) from case 1 and a nonsense variation (c.1873C>T/p.Arg625*) from case 2 and case 3. Conclusions SETBP1-HD is a different phenotype from Schinzel-Giedion syndrome. The main clinical features of SETBP1-HD are intellectual disabilities, speech and language disorder, and motor developmental retardation. Speech and language disorders are the core symptoms of the disease. Some patients may have behavioral problems and convulsive seizures. Loss of function variation in SETBP1 resulting in haploinsufficiency is the cause of this disease. Patients can benefit partially from supportive treatment such as rehabilitation training, behavioral therapy, and anticonvulsant medication. Prenatal diagnosis is an important measure to prevent this disease.

Relationship between blood lipids and age, coronary artery disease and its severity in the acute stage of Kawasaki disease

HE Fangyuan, HE Xuehua, YUAN Yonghua, ZHU Liurong, WU Yi, XIA Xiaohui

Journal of Clinical Pediatrics. 2023, 41(6): 455-458. doi:10.12372/jcp.2023.22e1030

Abstract ( 125 )

HTML ( 3 )

PDF (1225KB) ( 101 )

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the relationship between the changes of blood lipid and age, coronary artery disease and its severity in children with Kawasaki disease (KD). Methods A total of 241 children with acute KD admitted from January 2018 to December 2020 were selected as the study subjects (KD group), and 30 healthy children who underwent physical examination in our hospital were selected as the control group. The levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C) were compared between the two groups. The differences in blood lipid levels among KD children of different ages, with or without coronary artery lesions (CAL) and with different severity of CAL were compared. Results There were 241 patients (135 boys and 106 girls) in KD group, and the median age was 2.17 (1.04-4.00) years. Forty children were <1 year old, 120 were 1-3 years old, and 81 were >3 years old. There were 94 children in the CAL group and 147 in the non-CAL group. In the CAL group, 68 children were grade Ⅱ, 17 were grade Ⅲ and 9 were grade Ⅳ. The control group included 30 patients (14 boys and 16 girls) and the median age was 3.00 (2.00-5.00) years. The TG and LDL-C levels of KD children in the acute stage were significantly higher than those in the control group, while the levels of TC and HDL-C were significantly lower than those in the control group, and there were statistically significant differences (P<0.05). There were statistically significant differences in TG among different age groups (P<0.05), and TG showed a decreasing trend with the increase of age. TG in the CAL group was significantly higher than that in the non-CAL group, and the difference was statistically significant (P<0.05). There were statistically significant differences in TG among CAL groups with different severity (P<0.05). Conclusions In the acute stage of KD, the levels of TC and HDL-C were decreased, while the levels of TG and LDL-C were increased. The TG level was correlated with the age, whether CAL was complicated or not, and the severity of CAL in KD children.

Clinical analysis of 558 hospitalized children with human metapneumovirus pneumonia

LIU Xiaolan, LUO Xiaojuan, FENG Zhiguan, LIU Chunyan, BAO Yanmin, ZHENG Yuejie

Journal of Clinical Pediatrics. 2023, 41(6): 459-463. doi:10.12372/jcp.2023.22e0294

Abstract ( 206 )

HTML ( 10 )

PDF (1250KB) ( 127 )

Figures and Tables | References | Related Articles | Metrics

Objective To analyze the clinical characteristics of human metapneumovirus (hMPV) pneumonia in children and the risk factors for severe hMPV pneumonia. Methods The clinical data of children with hMPV pneumonia hospitalized from October 2020 to March 2021 were retrospectively analyzed. The patients were divided into mild group and severe group for comparative analysis. Results A total of 558 patients (309 boys and 249 girls) with hMPV pneumonia were included, and the median age was 3.4 (1.7-4.4) years. There were 515 children in mild group and 43 in severe group. One hundred and nine children were complicated with underlying disease. Compared with the mild group, the severe group had a higher proportion of children younger than 3 years old and with a history of underlying diseases, and the difference was statistically significant (P<0.05). The main clinical manifestations of children with hMPV pneumonia were fever (85.0%), cough (96.4%), wheezing (39.8%) and pulmonary moist rales (74.0%). Extra-pulmonary manifestations such as vomiting were rare. One hundred and thirteen patients had bacterial infection, and Streptococcus pneumoniae was the commonest (54 cases). The rate of antibiotic use was higher in hospitalized children with hMPV pneumonia (50.7%, 283 cases). The proportion of wheezing, shortness of breath, wheezing sound, pleural effusion and atelectasis, the level of WBC and CRP in peripheral blood and the proportion of bacterial infection in the severe group were higher than those in the mild group, and the difference was statistically significant (P<0.05). Compared with the mild group, the proportion of oxygen therapy, alveolar lavage, antibiotics and systemic glucocorticoids use in the severe group was higher, the hospital stay was longer, and the difference was statistically significant (P<0.05). Binary logistic regression analysis showed that age <3 years old, wheezing, complicated underlying diseases and CRP≥25mg/L were risk factors for severe hMPV pneumonia (P<0.05). Conclusions The main manifestations of hMPV are fever, cough, wheezing and moist rale in the lungs which is easy to be complicated with bacterial infection, but extra-pulmonary complications are rare and the overall prognosis is good. However, for children < 3 years old, children with wheezing, underlying disease, and elevated CRP need to be alert to severe pneumonia.

Clinical and genetic analysis of neonatal onset chronic granulomatous disease

HUANG Lilian, CHEN Jielin, LI Yingqiao, PANG Xialing, TAN Jie, HUANG Huiping, FENG Yanhua, Qin Min, LUO Jingsi

Journal of Clinical Pediatrics. 2023, 41(6): 464-469. doi:10.12372/jcp.2023.22e0232

Abstract ( 106 )

HTML ( 6 )

PDF (1349KB) ( 83 )

Figures and Tables | References | Related Articles | Metrics

Objective The clinical characteristics of 9 cases of neonatal onset of chronic granuloma (CGD) were analyzed to explore the clues of early diagnosis of CGD. Methods The family history, clinical manifestations, auxiliary examination, treatment and prognosis of 9 patients with neonatal-onset CGD were summarized and analyzed. Results All the 9 patients were boys. The median age of onset was 15 days, and the median age of diagnosis was 36 days. At the onset of the disease, there were fever, shortness of breath and difficulty breathing, and 6 cases had coughing. In all patients, the white blood cells measured for the first time ranged from 11.00 ×10⁹/L to 30.51×10⁹/L and were characterized by elevated neutrophils. CRP levels ranged from 37.16 mg/L to 186.30 mg/L. Multiple nodules and mass high density shadows were seen in CT of the lungs. All 9 patients had pulmonary aspergillosis. Respiratory burst test was positive in 2 cases. There were 7 cases of CYBB gene variation and 1 case of NCF1 gene variation. Three patients died, 5 survived and 1 lost follow-up. Conclusions In case of pulmonary aspergillosis infection in neonatal stage, we should be alert to CGD when the imaging changes mainly include multiple pulmonary node shadow and mass high density shadow. The most common variant gene of neonatal CGD is CYBB. The genotype can be frame-shifting, missense, splicing and nonsense mutations. The relationship between genotype and clinical phenotype needs to be further explored.

Analysis of the plasma amino acid spectrum of congenital bile acid synthesis disorder type 2

SHE Lanhui, LI Xufang, YE Jiawei, TAN Limei, YANG Huamei, FANG Chunxiao, LIAO Kaili, XU Yi

Journal of Clinical Pediatrics. 2023, 41(6): 470-474. doi:10.12372/jcp.2023.22e0229

Abstract ( 107 )

HTML ( 5 )

PDF (1275KB) ( 80 )

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the changes of plasma amino acid spectrum and its clinical significance in infants with CBAS2(congenital bile acid synthesis disorder type 2 ). Methods The clinical data of children with infantile cholestasis treated from January 2016 to June 2021 were retrospectively analyzed. According to the etiology, they were divided into CBAS2 group, neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD ) group and idiopathic neonatal intrahepatic hepatitis (INH) group. The differences of 22 amino acids in plasma among the three groups were compared. Results A total of 85 infantile cholestasis patients (58 boys and 27 girls) were included, and the median age was 2.3 (2.0-4.0) months. The median total bilirubin was 134.9 (103.1-181.7) μmol/L, and the median direct bilirubin was 79.0 (62.2-110.6) μmol/L. Among the 12 patients in CBAS2 group, 3 or more amino acids changed in 11 patients (91.7%) and branched chain amino acid (leucine, isoleucine and valine) was normal in 11 patients (91.7%). In the INH group, 17 (73.9%) of the 23 patients had≥3 amino acid changes. All the 50 patients in NICCD group had ≥3 amino acid changes. Compared with INH group, the levels of asparagine, serine, threonine and tyrosine in CBAS2 and NICCD groups were higher. Compared with NICCD group, the levels of glutamine, alanine, tryptophan, leucine and alanine/citrulline were higher, while the levels of citrulline, arginine, methionine, basic amino acid and threonine/serine were lower in CBAS2 group, and the differences were statistically significant (P<0.05). Conclusions Plasma amino acid spectra in children with CBAS2 vary widely. The changes of plasma amino acid spectra in CBAS2 children are different from those in NICCD and INH children, which is of great significance for the diagnosis and differential diagnosis of CBAS2.

Advances in studies on risk factors and predictors of patent hemodynamically significant ductus arteriosus in premature infants

ZHAO Caiyan, SUN Xuan, CHEN Ling

Journal of Clinical Pediatrics. 2023, 41(6): 475-479. doi:10.12372/jcp.2023.22e0327

Abstract ( 164 )

HTML ( 12 )

PDF (1206KB) ( 300 )

References | Related Articles | Metrics

Objective Patent ductus arteriosus (PDA) is a common complication in premature infants. When it progresses to PDA with significant hemodynamics (hsPDA), it can seriously affect neonatal outcomes. Recent studies have found that some perinatal factors, platelet-related parameters, brain natriuretic peptide and ultrasound indicators can predict the occurrence of hsPDA and form an artificial intelligence prediction model. However, some predictors are still controversial, and further research is needed to build a sensitive, accurate and easy-to-use prediction model for targeted treatment of high-risk children to improve the prognosis of premature babies.

Table of Content