摘要
目的探讨血清内皮素1(endothelin 1,ET-1)、高迁移率族蛋白B1(high mobility group box B1,HMGB1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)在新生儿持续肺动脉高压(persistent pulmonary hypertension of the newborn,PPHN)中的水平变化及对预后的影响。方法选取作者医院2019-01/2022-01月86例PPHN患儿作为观察组,另选取同期健康新生儿86例作为对照组。比较两组患儿血清ET-1、HMGB1、VEGF水平。分析各血清指标与病情程度的相关性。随访至治疗结束,根据预后分为预后良好患儿与预后不良患儿。比较不同预后患儿血清ET-1、HMGB1、VEGF水平,分析各血清指标水平对预后的影响及预测价值。结果观察组血清ET-1、HMGB1、VEGF水平高于对照组(P均<0.05);PPHN重度患儿血清ET-1、HMGB1、VEGF水平>中度患儿>轻度患儿(P均<0.05)。血清ET-1、HMGB1、VEGF水平与PPHN病情程度呈正相关(P均<0.05)。随访至治疗结束,观察组预后良好65例,预后不良21例(症状无改善转上级医院治疗17例,死亡4例)。预后不良患儿血清ET-1、HMGB1、VEGF水平高于预后良好患儿(P均<0.01)。血清ET-1、HMGB1、VEGF高水平PPHN患儿发生预后不良的风险分别是低水平患儿的1.897倍、1.876倍、2.229倍。血清ET-1、HMGB1、VEGF联合预测PPHN患儿预后不良的AUC为0.908(95%CI:0.827~0.960),大于三者单独预测。结论血清ET-1、HMGB1、VEGF在PPHN中呈异常升高表达,与病情程度呈正相关,联合检测可作为预测预后的重要辅助手段。
Objective To investigate the effects of serum endothelin 1(ET-1),high mobility group box B1(HMGB1)and vascular endothelial growth factor(VEGF)in persistent pulmonary hypertension of the newborn(PPHN)and their prognostic effects and its influence on prognosis.Methods Eighty-six children with PPHN in author′s hospital from January 2019 to January 2022 were selected as the observation group,and another 86 healthy newborns in the same period were selected as the control group.The levels of serum ET-1,HMGB1 and VEGF in children were compared between the two groups,and the correlation between each serum index and the degree of disease was analyzed.The children were followed up until the end of treatment,which were divided into children with good prognosis and children with poor prognosis according to their prognosis.The levels of serum ET-1,HMGB1 and VEGF of children with different prognosis were compared,and the influence and predictive value of each serum index level on prognosis were analyzed.Results The levels of serum ET-1,HMGB1 and VEGF were higher in the observation group than in the control group(all P<0.05);the levels of serum ET-1,HMGB1 and VEGF in PPHN children with severe disease>children with moderate disease>children with mild disease(all P<0.05).The levels of serum ET-1,HMGB1 and VEGF were positively correlated with the degree of PPHN disease(all P<0.05).At the end of follow-up,there were 65 cases with good prognosis and 21 cases with poor prognosis in the observation group,of which 17 cases were transferred to superior hospitals for treatment without improvement of symptoms and 4 cases died.The levels of serum ET-1,HMGB1 and VEGF in children with poor prognosis were higher than those in children with good prognosis(all P<0.01).The risk of poor prognosis in PPHN children with high levels of serum ET-1,HMGB1 and VEGF was 1.897,1.876 and 2.229 times higher than that in children with low levels respectively.The AUC of 0.908(95%CI:0.827-0.960)for the combination of serum ET-1,HMGB1 and VEGF to predict poor prognosis in children with PPHN was greater than the three alone.Conclusion Serum ET-1,HMGB1 and VEGF showed abnormally elevated expression in PPHN,which positively correlated with the extent of disease,and the combined assay can be an important supplementary means adjunct in predicting prognosis.
作者
滕飞
刘勇乐
林茂增
黄亿彩
TENG Fei;LIU Yongle;LIN Maozeng;HUANG Yicai(Department of Pediatrics,NO.909 Hospital of Joint Logistics Support Force of People's Liberation Army,Southeast Hospital Affiliated to Xiamen University,Zhangzhou Fujian 363000,China)
出处
《联勤军事医学》
CAS
2023年第1期48-52,共5页
Military Medicine of Joint Logistics
关键词
新生儿持续肺动脉高压
内皮素1
高迁移率族蛋白B1
血管内皮生长因子
预后
Persistent pulmonary hypertension of the newborn
Endothelin 1
High mobility group box B1
Vascular endothelial growth factor
Prognosis
