MRI联合血清HMGB1对新生儿缺氧缺血性脑病的诊断及预后评估价值分析  

The Value of MRI Combined with Serum HMGB1 in the Diagnosis and Prognosis Evaluation of Neonatal Hypoxic-ischemic Encephalopathy

作　　者：沙俏丽[1] 朱丽婕[1] 付娇慧 SHA Qiaoli;ZHU Lijie;FU Jiaohui(Department of Radiology,Dalian Children’s Hospital,Dalian 116001,Liaoning Province,China)

机构地区：[1]大连市儿童医院放射科,辽宁大连116001

出　　处：《中国实用乡村医生杂志》2022年第7期68-72,共5页Chinese Practical Journal of Rural Doctor

摘　　要：目的 探究磁共振成像(MRI)联合血清高迁移率族蛋白B1(HMGB1)对新生儿缺氧缺血性脑病(HIE)的诊断及预后评估价值。方法 选取大连市儿童医院2020年12月—2021年12月收治的105例足月HIE患儿作为研究对象,依据患儿疾病进展分为轻度组(42例)、中度组(33例)与重度组(30例)。所有新生儿出生第3天时均接受MRI检查及血清HMGB1检测,对比不同组别患儿MRI影像学评分及血清HMGB1水平差异。依据患儿出生后28d是否生存分为生存组(74例)与死亡组(31例),比较两组患儿MRI影像学评分及血清HMGB1水平,通过受试者工作特征(ROC)曲线分析MRI与血清HMGB1对HIE预后的诊断价值。结果 不同临床分度HIE患儿MRI影像学各项评分、血清HMGB1水平的组间差异有统计学意义(P<0.05);轻度组HIE患儿MRI评分中分水岭区、基底节或丘脑、内囊后肢、脑干及总分、血清HMGB1水平均低于中度组与重度组,中度组HIE患儿MRI各项评分及HMGB1水平均低于重度组,差异均有统计学意义(P<0.05)。生存组患儿MRI评分中分水岭区、基底节或丘脑、内囊后肢、脑干及总分、血清HMGB1水平均低于死亡组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,MRI、血清HMGB1诊断HIE患儿预后的AUC依次为0.896、0.812、0.912,敏感度依次为87.8%、87.8%、91.9%,特异度依次为90.3%、67.7%、90.3%,差异有统计学意义(P<0.05)。结论 HIE患儿表现为MRI评分及血清HMGB1水平的上升,且随着两项水平上升,疾病进展越严重,联合两项指标对患儿预后具有较好的诊断价值,值得临床参考借鉴。Objective To explore the diagnostic and prognostic vale of magnetic resonance imaging(MRI) combined with serum high mobility group protein 1(HMGB1) in neonatal hypoxic-ischemic encephalopathy(HIE).Methods A total of 105 full-term children with HIE who were admitted to our hospital from December 2020 to December 2021 were prospectively selected as the research subjects.According to the disease progression of the children,they were divided into mild group(42 cases),moderate group(33 cases) and Severe group(30 cases).All neonates received MRI examination and serum HMGB1 detection on the 3rd day of birth,and MRI imaging scores and serum HMGB1 levels were compared among the different groups.Children were divided into the survival group(74cases) and the death group(31 cases) according to whether they survived 28 days after birth.The MRI imaging scores and serum HMGB1 levels of the two groups were compared.The diagnostic and prognostic value of MRI and serum HMGB1 was evaluated using receiver operating characteristic curve(ROC) in HIE.Results The differences in MRI imaging scores and serum HMGB1 levels of children in different clinical grades of HIE were significant(P<0.05).The MRI scores of watershed,basal ganglia or thalamus,posterior limbs of the internal capsule,and brainstem,total scores,and serum HMGB1 levels in mild group were significantly lower than those in the moderate group and severe group(P<0.05).The MRI scores and HMGB1 levels in the moderate group were significantly lower than those in the severe group(P<0.05).The MRI scores of watershed area,basal ganglia or thalamus,posterior limbs of the internal capsule,and brain stem,total score,and serum HMGB1 level in the survival group were significantly lower than those in the death group(P<0.05).ROC curve analysis showed that the AUC of MRI,serum HMGB1,and combination of MRI and serum HMGB1 were 0.896,0.812,and 0.912,respectivly.The sensitivity was 87.8%,87.8%,91.9%,and the specificity was 90.3%,67.7%,90.3%(P<0.05).Conclusion Children with HIE showed an increas

关 键 词：磁共振成像 高迁移率族蛋白B1 新生儿缺氧缺血性脑病 诊断价值 预后评估 

分 类 号：R722.1[医药卫生—儿科] R816.92[医药卫生—临床医学]