摘要
目的探讨外周血高迁移率族蛋白B1(HMGB1)水平与早产儿呼吸窘迫综合征(RDS)的相关性及其临床应用价值。方法选取胎龄<32周龄的早产患儿、胎龄为32~37周龄的早产儿、胎龄>37周龄的正常新生儿及引起新生儿呼吸困难的其他疾病患儿各80例。收集新生儿或早产儿出生后的相关临床资料。采用酶联免疫吸附试验(ELISA)检测新生儿出生6和24 h时的外周血HMGB1水平。采用受试者工作特征(ROC)曲线评估外周血HMGB1水平判断RDS患儿预后的价值。结果<32周早产儿组RDS患病率、致死率及出生6、24 h的血清HMGB1水平均明显高于32~37周早产儿组及足月新生儿组(P<0.05、P<0.01),且32~37周早产儿组均明显高于足月新生儿组(P<0.05、P<0.01)。<32周早产儿组、32~37周早产儿组和疾病对照组出生24 h的血清HMGB1水平明显高于6 h(P<0.05),而足月新生儿组出生6 h与24 h的血清HMGB1水平差异无统计学意义(P>0.05)。疾病对照组出生6和24 h的血清HMGB1水平明显高于足月新生儿组和32~37周早产儿组(P<0.05),但低于<32周早产儿组(P<0.05)。240名早产儿和足月新生儿中有RDS患儿92例,其中死亡60例、存活32例,其余148名新生儿均正常。疾病对照组死亡24例、存活56例。RDS死亡患儿出生6 h的血清HMGB1水平明显高于RDS存活患儿和正常新生儿(P<0.01),RDS存活患儿血清HMGB1水平高于正常新生儿(P<0.05)。疾病对照组中死亡患儿出生6 h的血清HMGB1水平明显高于存活患儿,且分别与RDS存活、死亡患儿比较,差异均无统计学意义(P>0.05)。ROC曲线分析结果显示,HMGB1鉴别RDS患儿与正常新生儿、RDS存活患儿与RDS死亡患儿的曲线下面积(AUC)分别为0.88、0.81,最佳临界值分别为668.63、698.29 pg/mL,敏感性分别为96.78%、100.00%,特异性分别为75.35%、57.65%。结论血清HMGB1水平可反映RDS的病情进展,可作为RDS病情评价和预后判断的指标之一。
Objective To study the correlation between the level of peripheral blood high mobility group protein B1(HMGB1)and respiratory distress syndrome(RDS)in premature infants,and to investigate the role of HMGB1.Methods A total of 80 cases of<32-week premature infants,80 cases of 32-37-week premature infants and 80 cases of>37-week infants were enrolled.The clinical data were collected.Enzyme-linked immunosorbent assay(ELISA)was used to determine HMGB1 levels in peripheral blood of infants at postnatal 6 and 24 h.Receiver operating characteristic(ROC)curve was used to evaluate peripheral blood HMGB1 level in the prognosis of children with RDS.Results The prevalence rate of RDS,the mortality rate and serum HMGB1 levels at postnatal 6 and 24 h in<32-week group were higher than those in 32-37-week group and>37-week group(P<0.05,P<0.01),and those in 32-37-week group were higher than those in>37-week group(P<0.05,P<0.01).Serum HMGB1 levels at postnatal 24 h in<32-week and 32-37-week groups were higher than those at postnatal 6 h(P<0.05),while serum HMGB1 levels at postnatal 6 and 24 h in>37-week group had no statistical significance(P>0.05).Serum HMGB1 levels in disease control group at postnatal 6 and 24 h were higher than those in>37-week group and 32-37-week group(P<0.05),but they were lower than those in<32-week group(P<0.05).There were 92 in 240 infants with RDS,including 60 cases of death and 32 cases of survival,and the other 148 infants were normal.In the disease control group,2 cases died,and 56 cases survived.Serum HMGB1 level at postnatal 6 h in death group was higher than those in survival group and normal infants(P<0.01).Serum HMGB1 level in survival group was higher than that in normal infants(P<0.05).Serum HMGB1 level of dead cases at postnatal 6 h in disease control group was higher than that of survived cases.There was no statistical significance between dead and RDS survived cases(P>0.05).ROC curve analysis showed that the areas under ROC curves(AUC)of HMGB1 identifying RDS and normal infants and RDS survival and death were 0.88 and 0.81,respectively.The optimal cut-off values were 668.63 and 698.29 pg/mL,respectively.The sensitivities were 96.78%and 100.00%,respectively,and the specificities were 75.35%and 57.65%,respectively.Conclusions Serum HMGB1 level can reflect the disease progression of RDS and can be used as one of the indicators for RDS disease evaluation and prognosis.
作者
涂菊
彭海燕
TU Ju;PENG Haiyan(Department of Pediatrics,the First People's Hospital of Kunming,Kunming 650000,Yunnan,China)
出处
《检验医学》
CAS
2019年第7期617-621,共5页
Laboratory Medicine
关键词
高迁移率族蛋白B1
呼吸窘迫综合征
早产儿
High mobility group protein B1
Respiratory distress syndrome
Premature infant
