摘要
目的检测母亲妊娠高血压病(HDCP)新生儿脐血及脐带组织S100B、巨噬细胞炎性蛋白-1α(MIP-1α)的表达,探讨脐血S100B、MIP-1α对母亲HDCP新生儿脑损伤的早期诊断价值。方法将97例HDCP母亲所生新生儿纳入实验组,并根据其出生后7 d或纠正胎龄40周后7 d的20项新生儿神经行为测定(NBNA)评分分为2组:≤35分为脑损伤组(A组),>35分为非脑损伤组(B组);同时选取20例健康母亲所生健康新生儿作为健康对照组(C组)。免疫组织化学法检测其脐带组织S100B、MIP-1α表达;ELISA检测其脐血S100B蛋白、MIP-1α水平。评估脐血S100B、MIP-1α蛋白对母亲HDCP新生儿脑损伤的早期诊断价值。结果1.A、B、C组脐带组织S100B表达差异无统计学意义(P>0.05);A、B组脐血S100B蛋白水平均较C组增高(Pa<0.05)。2.A、B组脐带组织MIP-1α表达差异无统计学意义(P>0.05),但2组脐带组织MIP-1α表达与C组比较差异均有统计学意义(Pa<0.05);A、B组脐血MIP-1α水平均较C组增高(Pa<0.05)。3.A、B组脐血S100B蛋白水平、MIP-1α蛋白水平均与NBNA评分均呈负相关(Pa<0.05);脐血S100B蛋白水平与MIP-1α蛋白水平呈正相关(P<0.05)。4.脐血S100B蛋白ROC曲线下面积为0.992,以95.04 mg.L-1作为S100B的最佳截取值,诊断脑损伤的特异度为94.0%、灵敏度为95.7%;脐血MIP-1α蛋白ROC曲线下面积为0.928,以101.34 pg.L-1作为MIP-1α的最佳截取值时,诊断脑损伤的特异度为82.0%、灵敏度为87.2%。结论脐血S100B蛋白是母亲HDCP新生儿脑损伤早期诊断的可靠指标,且可反映脑损伤程度。MIP-1α对母亲HDCP新生儿脑损伤的早期诊断有一定意义。
Objective To observe the changes of S100B protein and macrophage inflammatory protein-1α（MIP-1α） in cord blood and umbilical cord of neonates whose mothers had hypertensive disorders complicating pregnancy（HDCP）,and explore the clinical significance of S100B and MIP-1α for early diagnosis on brain damage in those neonates. Methods Ninety-seven neonates whose mothers had HDCP were selected as case group and they were performed neonatal behavioral neurological assessment（NBNA） at the age of 7 days on full-term newborns or the corrected age of preterm infants.According to NBNA scores,they were divided into group A（NBNA scores≤35） and group B（NBNA scores〉35）.Twenty healthy neonates were selected into healthy control group（group C） at the same time.Immunohistochemistry was used to measure the expressions of S100B and MIP-1α in umbilical cord and enzyme-linked immunosorbent assay（ELISA） was used to detect the umbilical cord blood levels of S100B protein and MIP-1α.The value of umbilical cord serum S100B protein and MIP-1α concentrations were evaluated by drawing ROC-curve and calculating the corresponding areas under them respectively with respect to early diagnosis on brain damage in neonates whose mothers had HDCP. Results 1.S100B was present in umbilical cord but no significant difference was found in 3 groups（P〉0.05）.The cord blood levels of S100B protein both in group A and in group B were significantly higher than that in group C（Pa〈0.05）.2.The expression of MIP-1α had no significant difference between group A and group B（P〉0.05）,but the expressions of MIP-1α in the 2 groups were both significantly higher than that in group C（Pa〈0.05）.The cord blood levels of S100B protein both in group A and in group B were significantly higher than that in group C（Pa〈0.05）.3.In case group,the umbilical cord serum S100B and MIP-1α concentrations were both negatively correlated with the value of NBNA scores（P〈0.05）.The value of the umbilical cord serum MIP-1α concentrations was negatively correlated with the value of the level of MIP-1α in cord blood（P〈0.05）.4.The corresponding area under ROC-curve of the umbilical cord serum S100B protein concentration was 0.992.Taking the cord level 95.04 mg·L-1 of S100B protein as the optimal cutoff value,the sensitivity of the umbilical cord serum S100B protein was 95.7% to diagnose brain damage in neonates whose mothers had HDCP and the specificity of which was 94.0%.The corresponding areas under ROC-curve of the umbilical cord serum MIP-1α concentration was 0.928.Taking the cord level 101.34 pg·L-1 of MIP-1α as the optimal cutoff value,the sensitivity of the umbilical cord serum MIP-1α was 87.2% to diagnose brain damage in neonates whose mothers had HDCP and the specificity of which was 82.0%. Conclusions Cord blood levels of S100B protein can be used as a reliable biochemical index for diagnosing brain damage early and evaluating the extent of brain damage in neonates whose mothers had HDCP.Cord blood levels of MIP-1α have significances of early diagnosis of brain damage in neonates whose mothers had HDCP.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第12期925-927,933,共4页
Journal of Applied Clinical Pediatrics
关键词
妊娠高血压病
S100B
巨噬细胞炎性蛋白-1Α
脐血
脑损伤
hypertensive disorder complicating pregnancy； S100B protein； macrophage inflammation protein-1α； cord blood； brain damage
