中重度新生儿缺氧缺血性脑病患儿血清尿酸、Tau蛋白水平变化及其与窒息程度、神经发育预后的相关性研究  

Changes of Serum Levels of Uric Acid and Tau Protein and Their Correlations with Asphyxia Degree and Neurodevelopmental Prognosis in Neonates with Moderate to Severe Hypoxic Ischemic Encephalopathy

作　　者：王秋丽[1] 吕红艳[1] 董志勇[1] 李军勤 温志杰 霍海花 杨志华 WANG Qiuli;LYU Hongyan;DONG Zhiyong;LI Junqin;WEN Zhijie;HUO Haihua;YANG Zhihua(Handan Maternity and Child Centers Care,Handan 056001,China;Wu'an First People's Hospital,Wu'an 056300,China)

机构地区：[1]河北省邯郸市妇幼保健院,056001 [2]武安市第一人民医院,河北省邯郸市056300

出　　处：《实用心脑肺血管病杂志》2019年第12期47-52,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河北省科技计划项目(162777201);河北省医学科学研究重点课题计划项目(20150033);邯郸市科学技术研究与发展计划项目(152810879-6)

摘　　要：背景部分生物学标志物可用于新生儿缺氧缺血性脑病(HIE)的诊断及其预后评估,但目前血清尿酸、Tau蛋白水平与新生儿HIE患儿神经发育预后的关系尚未明确。目的分析中重度新生儿HIE患儿血清尿酸、Tau蛋白水平变化及其与窒息程度、神经发育预后的相关性。方法选取2014年8月-2015年8月邯郸市妇幼保健院新生儿重症监护室收治的中重度新生儿HIE患儿41例作为观察组,另选取同期在本院出生的健康足月新生儿35例作为对照组。比较两组新生儿、中重度患儿、不同神经发育预后患儿血清尿酸、Tau蛋白水平及出生5 min Apgar评分;血清尿酸水平与中重度新生儿HIE患儿血清Tau蛋白水平、出生5 min Apgar评分、总发育商的相关性及血清Tau蛋白水平与中重度新生儿HIE患儿出生5 min Apgar评分、总发育商的相关性分析采用Pearson相关分析。结果 (1)观察组患儿血清尿酸、Tau蛋白水平高于对照组,出生5 min Apgar评分低于对照组(P<0.01)。(2)重度患儿血清尿酸、Tau蛋白水平高于中度患儿,出生5 min Apgar评分低于中度患儿(P<0.05)。(3)不同神经发育预后患儿血清尿酸水平比较,差异无统计学意义(P>0.05);边缘状态和发育迟缓患儿血清Tau蛋白水平高于发育良好患儿,发育迟缓患儿出生5 min Apgar评分低于发育良好患儿(P<0.05)。(4)Pearson相关分析结果显示,血清尿酸水平与中重度新生儿HIE患儿血清Tau蛋白水平(r=0.299,P=0.097)、总发育商(r=-0.203,P=0.256)无直线相关关系,但与出生5 min Apgar评分呈负相关(r=-0.729,P<0.01);血清Tau水平与中重度新生儿HIE患儿出生5 min Apgar评分(r=-0.370,P=0.017)、总发育商(r=-0.617,P<0.01)呈负相关。结论中重度新生儿HIE患儿出生后24 h内血清尿酸、Tau蛋白水平明显升高,二者均与患儿出生时窒息程度有关;血清Tau蛋白水平与患儿神经发育预后呈负相关,而血清尿酸水平与患儿神经发育预后无直线Background Some biomarkers may used to the diagnosis and evaluation of prognosis in neonates with hypoxic ischemic encephalopathy(HIE),however correlations of serum levels of uric acid and Tau protein with neurodevelopmental prognosis in neonates with HIE are not yet clear. Objective To analyze the changes of serum levels of uric acid and Tau protein and their correlations with asphyxia degree and neurodevelopmental prognosis in neonates with moderate to severe HIE. Methods From August 2014 to August 2015,a total of 41 neonates with moderate to severe HIE were selected as observation group in NICU Handan Maternity and Child Centers Care,meanwhile 35 full-term healthy neonates were selected as control group. Serum levels of uric acid and Tau protein,Apgar score 5 minutes after birth were compared between the two groups,between moderate and severe neonates with HIE,as well as in HIE neonates with neurodevelopmental prognosis;Pearson correlation analysis was used to analyze the correlations of serum uric acid level with serum Tau protein level,Apgar score 5 minutes after birth and overall development quotient in neonates with moderate to severe HIE,as well as correlations of serum Tau protein level with Apgar score 5 minutes after birth and overall development quotient. Results(1)Serum levels of uric acid and Tau protein in observation group were statistically significantly higher than those in control group,while Apgar score 5 minutes after birth in observation group was statistically significantly lower than that in control group(P<0.01).(2)Serum levels of uric acid and Tau protein in neonates with severe HIE were higher statistically significantly than those in neonates with moderate HIE,while Apgar score 5 minutes after birth in neonates with severe HIE was statistically significantly lower than that in neonates with moderate HIE(P<0.05).(3)There was no statistically significant difference in serum uric acid level in HIE neonates with different neurodevelopmental prognosis(P>0.05);serum Tau protein level in HIE

关 键 词：缺氧缺血性脑病 新生儿 尿酸 TAU蛋白 新生儿窒息 神经发育预后 

分 类 号：R743[医药卫生—神经病学与精神病学]