新生儿缺氧缺血性脑病血清神经丝蛋白轻链多肽表达水平及与预后的关系  

Expression level of neurofilament light polypeptide in serum of neonates with hypoxic-ischemic encephalopathy and its relationship with prognosis

作　　者：马燕春 王洪 蒲荣 Ma Yanchun;Wang Hong;Pu Rong(Department of Emergency,Qinghai Province Women and Children's Hospital,Qinghai,Xining 810700,China;Department of Pediatrics,Qinghai Province Women and Children's Hospital,Qinghai,Xining 810700,China)

机构地区：[1]青海省妇女儿童医院急诊内科,青海西宁810700 [2]青海省妇女儿童医院儿科,青海西宁810700

出　　处：《发育医学电子杂志》2022年第6期423-427,共5页Journal of Developmental Medicine (Electronic Version)

基　　金：青海省卫健委医药卫生科技项目(2020-wjzdx-93)。

摘　　要：目的观察新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)血清神经丝蛋白轻链多肽(neurofilament light polypeptide,NF-L)表达水平及与预后的关系。方法选取2018年3月至2019年3月青海省妇女儿童医院收治的124例HIE患儿纳入研究组,根据HIE临床严重程度分为轻度(n=41)、中度(n=47)、重度(n=36);并将同期出生的125例健康新生儿纳入对照组。血清NF-L水平采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)进行检测,比较研究组与对照组、不同严重程度HIE患儿的NF-L水平,采用受试者操作特性(receiver operator characteristic,ROC)曲线分析其对HIE患儿预后不良的预测价值。统计学方法采用t检验、单因素方差分析、χ^(2)检验。结果研究组患儿血清NF-L水平明显高于对照组[(145.9±30.8)与(1.3±0.4)ng/L],差异有统计学意义(t=52.460,P<0.05)。不同严重程度HIE患儿性别、出生胎龄、出生体质量比较,差异均无统计学意义(P值均>0.05)。轻、中、重度患儿血清NF-L水平[(116.4±15.7)、(153.2±20.9)与(170.0±28.2)ng/L]比较,差异有统计学意义(F=61.996,P<0.001);进一步两两比较,重度和中度患儿血清NF-L水平均高于轻度患儿,重度患儿血清NF-L水平高于中度患儿(P值均<0.05)。轻、中、重度HIE患儿预后不良比例[0.0%(0/41)、34.0%(16/47)与61.1%(22/36)]比较,差异有统计学意义(χ^(2)=34.093,P<0.001);进一步两两比较,重度和中度患儿预后不良比例均高于轻度患儿,重度患儿预后不良比例高于中度患儿(P值均<0.05)。预后不良患儿血清NF-L水平高于预后良好患儿[(169.8±26.7)与(135.3±20.4)ng/L],差异有统计学意义(t=7.872,P<0.001)。ROC曲线分析显示,血清中NF-L水平预测HIE患儿不良预后的曲线下面积为0.889(95%CI:0.827~0.951),截断值为140.6 ng/L,其灵敏度为85.7%、特异度为79.8%。结论不同严重程度HIE患儿的预后情况不同,NF-L可作为判定预后的血清指标,在临床上具有Objective To observe the expression level of neurofilament light polypeptide(NF-L)in serum of neonatal hypoxic-ischemic encephalopathy(HIE)and its relationship with prognosis.Method A total of 124 children with HIE admitted to Qinghai Province Women and Children's Hospital from March 2018 to March 2019 were included in the study group,according to HIE clinical severity classification,they were divided into mild(n=41),moderate(n=47)and severe(n=36);and 125 healthy neonates born in the same period were included in the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect the level of NF-L in serum,and to compare the level of NF-L between the study group,the control group and different severity HIE;receiver operator characteristic(ROC)curve was used to analyze its predictive value for the poor prognosis of children with HIE.Statistical methods performed by t-test,one-way ANOVA,χ^(2) test.Result The level of NF-L in the study group was significantly higher than that in the control group[(145.9±30.8)vs(1.3±0.4)ng/L],and the difference was statistically significant(t=52.460,P<0.05).There were no significant differences in gender,gestational age at birth and birth weight among children with different severity of HIE(all P>0.05).The levels of NF-L in serum of mild,moderate and severe children[(116.4±15.7),(153.2±20.9)and(170.0±28.2)ng/L]were significantly different(F=61.996,P<0.001).Further pairwise comparison showed that the serum level of NF-L in severe and moderate children was higher than that in mild children,and the serum levels of NF-L in severe children were higher than those in moderate children(all P<0.05).The proportion of poor prognosis in children with mild,moderate and severe HIE was compared[0.0%(0/41),34.0%(16/47)and 61.1%(22/36)],and the difference was statistically significant(χ^(2)=34.093,P<0.001).Further pairwise comparison showed that the proportion of severe and moderate children with poor prognosis was higher than that of mild children,and the proportion of severe children

关 键 词：新生儿缺氧缺血性脑病 血清 神经丝蛋白轻链多肽 预后 受试者操作特性曲线 

分 类 号：R722.1[医药卫生—儿科]