摘要
目的:探究血清脑源性神经营养因子(BDNF)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、超氧化物歧化酶(SOD)水平对新生儿缺氧缺血性脑病(HIE)严重程度及预后的评估价值。方法:回顾性分析68例HIE患儿的临床资料,根据病情严重程度将纳入患儿分为轻度组(n=27例)、中度组(n=23例)、重度组(n=18例),另选取同期50例健康新生儿作为正常对照组,均检测血清BDNF、IL-8、TNF-α、SOD水平,Spearman相关性分析血清BDNF、IL-8、TNF-α、SOD水平与HIE严重程度的关系,受试者工作特征曲线(ROC)分析血清BDNF、IL-8、TNF-α、SOD值单一或联合对HIE患儿预后的预测价值。结果:HIE组血清BDNF、SOD水平低于正常对照组(P<0.05),血清IL-8、TNF-α水平高于正常对照组(P<0.05);随着HIE病情加重,患儿血清BDNF、SOD水平逐渐降低,血清IL-8、TNF-α水平逐渐上升,组间两两比较差异均有统计学意义(P<0.05);Spearman相关性分析显示HIE患儿血清BDNF、SOD水平与病情严重程度呈显著负相关关系(r=-0.621、-0.598,P<0.05),IL-8、TNF-α与病情严重程度呈显著正相关关系(r=0.562、0.663,P<0.05);ROC分析结果显示联合预测HIE患儿预后结局曲线下面积(AUC)0.955大于BDNF、IL-8、TNF-α、SOD值单一预测0.805、0.754、0.855、0.762(P<0.05)。结论:血清BDNF、IL-8、TNF-α、SOD水平可用于评估HIE严重程度,可有效预测患儿预后。
Objective:To explore the evaluation value of serum brain-derived neurotrophic factor(BDNF),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α) and superoxide dismutase(SOD) levels for severity and prognosis of hypoxic-ischemic encephalopathy(HIE) in neonates.Methods:A retrospective analysis was performed on the clinical medical data of 68 HIE children.According to disease severity,they were divided into mild group(n=27),moderate group(n=23) and severe group(n=18).Another 50 healthy neonates during the same period were enrolled as normal control group.The levels of serum BDNF,IL-8,TNF-α and SOD were detected.Their relationship with HIE severity was analyzed by Spearman correlation analysis.The predictive value of serum BDNF,IL-8,TNF-α,SOD alone and their combination for prognosis of HIE neonates was analyzed by receiver operating characteristic(ROC) curve.Results:The levels of serum BDNF and SOD in HIE group were lower than those in normal control group(P<0.05),while the levels of serum IL-8 and TNF-α were higher than those in normal control group(P<0.05).As the exacerbation of HIE,the levels of serum BDNF and SOD were gradually decreased,while the levels of serum IL-8 and TNF-α were gradually increased,the differences between the groups were statistically significant(P<0.05).Spearman correlation analysis showed that the levels of serum BDNF and SOD were significantly negatively correlated with HIE severity(r=-0.621,-0.598,P<0.05),while the levels of IL-8 and TNF-α were significantly positively correlated with HIE severity(r=0.562,0.663,P<0.05).The analysis results of ROC curves showed that the area under the curve(AUC) of BDNF combined with IL-8,TNF-α and SOD for predicting prognosis of HIE childrenwas 0.955,which was greater than that of single index(0.805,0.754,0.855,0.762)(P<0.05).Conclusion:The levels of serum BDNF,IL-8,TNF-α and SOD can be applied to assess HIE severity,which can effectively predict prognosis.
作者
王俊姬
何平
薛泽恩
乔红
王文静
WANG Junji;HE Ping;XUE Ze'en(The Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000)
出处
《陕西医学杂志》
CAS
2020年第11期1465-1468,1522,共5页
Shaanxi Medical Journal
