摘要
目的:探讨缺氧缺血性脑病(HIE)新生儿血清高迁移率族蛋白1(HMGB1)水平与炎症因子、新生儿行为神经测定(NBNA)评分的关系及其对预后的预测价值。方法:选取HIE患儿86例为观察组,并根据患儿出生后28 d是否存活分为死亡组(22例)和存活组(64例)。选取同期健康新生儿172例为对照组。采用酶联免疫吸附(ELISA)法测定血清HMGB1、炎症因子[白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]水平,并进行NBNA评分。比较观察组与对照组以及死亡组与存活组血清HMGB1、炎症因子水平和NBNA评分。比较不同HMGB1水平患儿炎症因子和NBNA评分。采用Pearson法分析HMGB1水平与炎症因子、NBNA评分的相关性。采用受试者工作特征(ROC)曲线分析HMGB1、IL-6、TNF-α水平及NBNA评分对HIE患儿预后的预测价值。结果:观察组血清HMGB1、IL-6、TNF-α水平高于对照组,NBNA评分低于对照组(均P<0.05)。死亡组血清HMGB1、IL-6、TNF-α水平高于存活组,NBNA评分低于存活组(均P<0.05)。HMGB1高水平组血清IL-6、TNF-α水平高于HMGB1低水平组,NBNA评分低于HMGB1低水平组(均P<0.05)。Pearson相关性分析显示,HMGB1与IL-6、TNF-α呈正相关(r=0.551、0.506,均P<0.05),与NBNA评分呈负相关(r=-0.572,P<0.05)。ROC曲线分析显示,HMGB1、IL-6、TNF-α水平及NBNA评分对HIE患儿出生后28 d死亡均具有一定的预测价值。结论:HIE患儿血清HMGB1水平与IL-6、TNF-α以及NBNA评分具有相关性,其水平变化可作为预测HIE患儿预后的参考指标。
Objective:To investigate the relationship between serum high mobility group box-1(HMGB1)level and inflammatory factors,neonatal behavioral neurological assessment(NBNA)score in neonates with hypoxic-ischemic encephalopathy(HIE)and its predictive value for prognosis.Methods:A total of 86 neonates with HIE were enrolled as observation group,and they were divided into death group(22 cases)and survival group(64 cases)according to whether they survived 28 days after birth.172 healthy children were selected as the control group during the same period.The levels of serum HMGB1,inflammatory factors(IL-6 and TNF-α)were measured by ELISA,and NBNA score was performed.Serum levels of HMGB1,inflammatory factors and NBNA scores were compared between observation group and control group,death group and survival group.The inflammatory factors and NBNA scores of children with different HMGB1 levels were compared.Pearson method was used to analyze the correlation between HMGB1 level and inflammatory factors,NBNA score.The ROC curve was used to analyze the predictive value of HMGB1,IL-6,TNF-α,and NBNA score for the prognosis of neonates with HIE.Results:The serum levels of HMGB1,IL-6 and TNF-αin the observation group were higher than those in the control group,and the NBNA score was lower than that in the control group(all P<0.05).The serum levels of HMGB1,IL-6 and TNF-αin the death group were higher than those in the survival group,and the NBNA score was lower than that in the survival group(all P<0.05).Compared with the low HMGB1 group,the high HMGB1 group had significantly higher serum levels of IL-6 and TNF-α,and significantly lower NBNA score(all P<0.05).Pearson correlation analysis showed that HMGB1 was positively correlated with IL-6 and TNF-α(r=0.551,0.506,all P<0.05),and negatively correlated with NBNA score(r=-0.572,P<0.05).ROC curve analysis showed that HMGB1,IL-6,TNF-α,and NBNA score all had certain predictive value for the death of HIE infants 28 days after birth.Conclusion:The serum level of HMGB1 is correlated with IL-6,TNF-α,and NBNA score in children with HIE,and its changes can be used as a reference index for predicting the prognosis of children with HIE.
作者
耿淑霞
GENG Shuxia(Department of Neonatology,Xingtai People’s Hospital,Xingtai 054000,China)
出处
《陕西医学杂志》
CAS
2023年第12期1688-1691,共4页
Shaanxi Medical Journal
基金
国家自然科学基金资助项目(81370439)
河北省邢台市重点研发计划项目(2023ZC)。
