尿乳酸/肌酐比值、Mb和cTnI在HIE中的表达及临床意义  

Expression and clinical significance of urinary lactate/creatinine ratio,Mb and cTnI in HIE

作　　者：龚晓燕 刘成博[1] 陈燕[1] 王利维[1] GONG Xiaoyan;LIU Chengbo;CHEN Yan;WANG Liwei(Department of Neonatology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai,China,200092)

机构地区：[1]上海交通大学医学院附属新华医院新生儿科,上海200092

出　　处：《分子诊断与治疗杂志》2022年第10期1753-1756,共4页Journal of Molecular Diagnostics and Therapy

基　　金：上海市科技计划项目(20YF1429200);新华医院护理学科建设项目(HLXKRC 2021001)。

摘　　要：目的 探讨尿乳酸/肌酐比值、肌红蛋白(Mb)及肌钙蛋白I(cTcI)在新生儿缺氧缺血性脑病(HIE)中的表达及临床意义。方法 收集2020年2月至2021年10月上海交通大学医学院附属新华医院收治的134例HIE患作为HIE组[采用Apgar评分分组:轻度≥7分(n=63,轻度组);中度4~6分(n=48,中度组);重度≤3分(n=23)],另选取同期本院足月出生的正常新生儿83例作为健康组。比较两组及不同病情HIE患儿尿乳酸/肌酐比值、Mb及c TnI水平,并分析上述指标检测诊断HIE患儿的价值。结果 HIE组尿乳酸/肌酐比值、Mb及cTnI水平均明显高于健康组,差异均有统计学意义(P<0.05)。不同病情HIE患儿尿乳酸/肌酐比值、Mb及c TnI水平比较:轻度组<中度组<重度组,差异均有统计学意义(P<0.05)。ROC曲线显示,三者(尿乳酸/肌酐比值+Mb+cTnI)联合检测诊断HIE的敏感度和特异度分别为0.915、0.769,AUC=0.859,明显高于各项单独预测(P<0.05)。结论 尿乳酸/肌酐比值、Mb及c TnI在HIE患儿中呈异常表达,通过检测上述指标对疾病诊断、病情程度判断具有一定参考价值。Objective To investigate the expression and clinical significance of urinary lactate/creatinine ratio,myoglobin(Mb)and cardiac troponin I(cTcI)in neonatal hypoxic-ischemic encephalopathy(HIE). Methods 134 HIE patients admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from February 2020 to October 2021 were collected as the HIE group[mild ≥ 7 points(n=63,mild group);moderate 4~6 points(n=48,moderate group);severe ≤ 3 points(n=23)],another 83normal neonates born at term in our hospital at the same time were selected as the healthy group. The urinary lactate/creatinine ratio,Mb and cTnI levels were compared between the two groups and in children with HIE with different conditions,and the the value of the above indicators to detect and diagnose children with HIE was analyzed. Results The urinary lactate/creatinine ratio,Mb and c TnI levels in the HIE group were significantly higher than those in the healthy group,and the differences were statistically significant(P<0.05). Comparison of urinary lactate/creatinine ratio,Mb and cTnI levels in children with HIE with different conditions:mild group < moderate group < severe group,the differences were statistically significant(P<0.05). The ROC curve showed that the sensitivity and specificity of the three combined(urinary lactate/creatinine ratio+Mb+cTnI)for the diagnosis of HIE were 0.915,0.769,and AUC=0.859,respectively,which were significantly higher than the individual predictions(P<0.05). Conclusion Urinary lactate/creatinine ratio,Mb and c TnI are abnormally expressed in children with HIE,and the detection of these indicators has certain reference value for disease diagnosis and disease severity judgment.

关 键 词：新生儿缺氧缺血性脑病 尿乳酸/肌酐比值 肌红蛋白 肌钙蛋白Ⅰ 

分 类 号：R742[医药卫生—神经病学与精神病学]