血清GM-CSF HMGB1联合检测对新生儿缺氧缺血性脑病预后的预测价值  

Predictive value of combined detection of serum GM-CSF and HMGB1 on prognosis of neonates with hypoxic-ischemic encephalopathy

作　　者：罗蓉 解丽洁 沈嵩喻 张正怀[1] LUO Rong;XIE Lijie;SHEN Songyu(Department of Laboratory Medicine,Guangyuan Maternal and Child Health Hospital,628000 Guangyuan,China)

机构地区：[1]广元市妇幼保健院检验科,四川广元628000

出　　处：《安徽医学》2021年第11期1240-1244,共5页Anhui Medical Journal

摘　　要：目的探讨血清高迁移率族蛋白B1(HMGB1F)联合粒细胞巨噬细胞集落刺激因子(GM-CS)对新生儿缺氧缺血性脑病(HIE)预后的预测价值。方法选取2018年2月至2020年10月广元市妇幼保健院收治的112例新生HIE患儿设为观察组,同期选择在本院出生的110例健康新生儿为对照组。比较两组对象血清GM-CSF、HMGB1水平;依据HIE患儿病情严重程度判定标准分为轻度组(49例)、中度组(37例)及重度组(26例),对比不同严重程度HIE患儿血清GM-CSF、HMGB1水平;依据HIE患儿出生后28 d是否存活分为死亡组(25例)和存活组(87例),通过单因素及多因素logistic回归分析影响新生HIE患儿死亡的因素。采用受试者工作特征曲线(ROC)分析联合检测血清GM-CSF、HMGB1对新生HIE患儿出生后28 d死亡的预测价值。结果观察组血清GM-CSF、HMGB1水平均高于对照组(P<0.05)。重度组HIE患儿血清GM-CSF、HMGB1水平均高于轻度组和中度组(P<0.05),中度组HIE患儿血清GM-CSF、HMGB1水平均高于轻度组(P<0.05)。logistic回归分析显示,开始治疗日龄偏大、重度HIE、血清GM-CSF偏高及HMGB1偏高均为影响HIE患儿预后的危险因素(P<0.05)。ROC分析结果显示血清GM-CSF、HMGB1两者联合预测HIE患儿出生后28 d死亡的曲线下面积(AUC)为0.853,高于血清GM-CSF、HMGB1单独预测的AUC(P<0.05)。结论血清GM-CSF、HMGB1水平在新生HIE患儿中偏高,两者联合检测对新生HIE患儿病情严重程度及预后评估的预测效能较高。Objective To investigate the prognostic value of serum high mobility group protein B1(HMGB1F)combined with granulocyte macrophage colony stimulating factor(GM-CS)on the prognosis of neonatal hypoxic-ischemic encephalopathy(HIE).Methods A total of 112 newborn children with HIE admitted to Guangyuan Maternity and Child Health Hospital from February 2018 to October 2020 were selected as the observation group,and 110 healthy newborns born in this hospital during the same period were selected as the control group.The serum GM-CSF and HMGB1 levels of the two groups were compared.Children with HIE were divided into mild group(49 cases),moderate group(37 cases)and severe group(26 cases)according to the criteria for determining the severity of HIE children.The serum GM-CSF and HMGB1 levels of children with HIE of different severity were compared.Children with HIE were divided into death group(25 cases)and survival group(87 cases)according to whether they were alive 28 days after birth.The factors affecting the death of newborn children with HIE were analyzed by univariate and multivariate logistic regression.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of combined detection of serum GM-CSF and HMGB1 on the 28 days death of newborn children with HIE.Results The levels of serum GM-CSF and HMGB1 in the observation group were higher than those in the control group(P<0.05).The levels of serum GM-CSF and HMGB1 in children with HIE in the severe group were higher than those in the mild and moderate groups(P<0.05).The levels of serum GM-CSF and HMGB1 in children with HIE in the moderate group were hig her than those in the mild group(P<0.05).Logistic regression analysis showed that older age at the beginning of treatment,severe HIE,higher serum GM-CSF and higher HMGB1 were all factors affecting the prognosis of children with HIE(P<0.05).ROC analysis showed that the area under the curve(AUC)predicted by the combination of serum GM-CSF and HMGB1 at 28 days after birth was 0.853,which was

关 键 词：新生儿 缺氧缺血性脑病 血清高迁移率族蛋白B1 粒细胞巨噬细胞集落刺激因子 预后 

分 类 号：R722.1[医药卫生—儿科]