血清IGF-1、NSE、MBP联合检查对新生儿黄疸脑损伤的诊断价值  

Diagnostic value of combined detection of serum IGF-1,NSE and MBP for neonatal jaundice and brain injury

作　　者：刘俊[1] 陈琦[1] 白如君[1] LIU Jun;CHEN Qi;BAI Ru-jun(Department of Laboratory Medicine,Tianyou Hospital,Wuhan University of Science and Technology,Wuhan Hubei 430064,China)

机构地区：[1]武汉科技大学附属天佑医院检验科,湖北武汉430064

出　　处：《临床和实验医学杂志》2020年第22期2447-2450,共4页Journal of Clinical and Experimental Medicine

基　　金：湖北省中医药中西医结合科研项目(编号:2013Z-Y46)。

摘　　要：目的探讨血清胰岛素样生长因子-1(IGF-1)、神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)联合检查对新生儿黄疸脑损伤的诊断价值,为其风险预测和治疗提供合理临床依据。方法回顾性选择2017年10月至2019年12月于武汉科技大学附属天佑医院出生并确定为黄疸新生儿128例,根据脑部CT或MRI诊断结果将其分为单纯黄疸组(n=71)和合并脑损伤组(n=57),选择同时期内于武汉科技大学附属天佑医院生产的健康新生儿57例作为健康组。收集各组患儿血清IGF-1、NSE、MBP值,采用相关系数分析IGF-1、NSE、MBP间的相关性及其与脑损伤发生相关性;建立ROC曲线探讨IGF-1、NSE、MBP联合检查对预测黄疸新生儿并发脑损伤的诊断价值。结果健康组血清IGF-1、NSE、MBP水平分别为(13.02±2.54)、(10.98±2.03)、(3.22±1.05)μg/L,单纯黄疸组分别为(40.05±3.78)、(29.77±2.71)、(4.39±1.56)μg/L,合并脑损伤组分别为(80.24±4.66)、(41.09±3.38)、(7.66±2.30)μg/L。较健康组,单纯黄疸组、合并脑损伤组患儿IGF-1、NSE、MBP水平均显著升高(P<0.05),合并脑损伤组患儿IGF-1、NSE、MBP水平高于单纯黄疸组(P<0.05)。IGF-1与NSE、MBP均呈正相关关系(r=0.516、0.488,P<0.05);IGF-1、NSE、MBP与脑损伤发生相关(P<0.05)。IGF-1、NSE、MBP诊断脑损伤的ROC曲线下面积(AUC)分别为0.787、0.793、0.661,IGF-1、NSE、MBP联合诊断的AUC、特异性和阳性预测值大于IGF-1、NSE、MBP单独或两两联合诊断(P<0.05)。结论黄疸并发脑损伤患儿血清IGF-1、NSE、MBP显著升高,联合检测可作为诊断脑损伤的预测因子,有望成为临床检测黄疸新生儿并发脑损伤的标志物。Objective To investigate the diagnostic value of serum insulin-like growth factor-1(IGF-1),neuron-specific enolase(NSE),and myelin basic protein(MBP)for neonatal jaundice and brain injury,and to provide clinical basis for the risk assessment and treatment.Methods 128 newborns with jaundice in Tianyou Hospital Wuhan University of Science and Technology,from October 2017 to December 2019 were enrolled,and divided into two groups according to the brain CT or MRI examinations,simple jaundice group(n=71)and brain injury group(n=57),meanwhile,another 57 healthy children were set as control group.Serum IGF-1,NSE and MBP levels were detected,and their correlations with brain injury was also analyzed;ROC curve was used to analyze the predictive value of serum IGF-1,NSE and MBP levels for brain injury in jaundice children.Results The serum levels of IGF-1,NSE and MBP in the healthy group were(13.02±2.54),(10.98±2.03),(3.22±1.05)μg/L,respectively.And in the simple jaundice group were(40.05±3.78),(29.77±2.71),(4.39±1.56)μg/L,respectively.The combined brain injury group were(80.24±4.66),(41.09±3.38),(7.66±2.30)μg/L,respectively.Serum IGF-1,NSE and MBP levels among three groups were the lowest in control group,followed by simple jaundice group and brain injury group,with statistic difference(P<0.05).IGF-1 was positively correlated with NSE and MBP(P<0.05).Serum IGF-1,NSE and MBP were correlated with brain injury(r=0.516,0.488,P<0.05).The area under the ROC curve of serum IGF-1,NSE and MBP in the diagnosis of brain injury was 0.787,0.793,and 0.661,respectively.The AUC,specificity,and positive predictive value of combined detection of the three were all better than those of single detection or paired detection(P<0.05).Conclusion Serum IGF-1,NSE and MBP are elevated in jaundice children complicated with brain injury,as predictive factors for brain injury,combined detection of the three can be used in the clinical diagnosis.

关 键 词：新生儿黄疸脑损伤 胰岛素样生长因子 神经元特异性烯醇化酶 髓鞘碱性蛋白 

分 类 号：R722.17[医药卫生—儿科] R742[医药卫生—临床医学]