血清ACTA、GFAP、HMGB1在新生儿缺血缺氧性脑病亚低温治疗前后的水平变化及与NBNA评分的关系  

Changes of serum ACTA,GFAP,HMGB1 levels before and after mild hypothermia treatment of neonatal hypoxic-ischemic encephalopathy and their relationship with NBNA scores

作　　者：陈娟 程艳峰 许玉峰 CHEN Juan;CHENG Yanfeng;XU Yufeng(Department of Pediatrics,Huaibei People′s Hospital,Huaibei,Anhui 235000,China)

机构地区：[1]安徽省淮北市人民医院儿科,安徽淮北235000

出　　处：《国际检验医学杂志》2022年第23期2912-2916,2924,共6页International Journal of Laboratory Medicine

基　　金：安徽省淮北市科学技术局研究项目(2020HK05)。

摘　　要：目的探讨血清内源性激活素A(ACTA)、胶质纤维酸性蛋白(GFAP)、高迁移率族蛋白B1(HMGB1)在新生儿缺血缺氧性脑病(HIE)亚低温治疗前后的水平变化及与新生儿行为神经测定(NBNA)评分的关系。方法回顾性选取2018年1月至2021年12月该院收治的84例HIE新生儿作为研究对象,按照治疗方法不同分为观察组、常规组,各42例。常规组采用常规治疗,观察组在常规组基础上加用亚低温治疗。比较两组疗效、症状改善/恢复时间,治疗前、治疗28 d后炎症因子[白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)],氧化应激指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)],血清ACTA、GFAP、HMGB1水平及NBNA评分,分析观察组治疗前、治疗28 d后血清ACTA、GFAP、HMGB1水平差值与NBNA评分差值的相关性。结果观察组总有效率为95.24%,高于常规组的总有效率(78.57%),差异有统计学意义(P<0.05)。观察组肌张力、意识、反射恢复时间及惊厥改善时间均较常规组短,差异有统计学意义(P<0.05)。治疗28 d后两组血清IL-1β、IL-6、TNF-α水平均较治疗前降低,且观察组低于常规组,差异有统计学意义(P<0.05)。治疗28 d后两组血清GSH-Px、SOD水平较治疗前升高,MDA水平较治疗前降低,且观察组血清MDA水平低于常规组,GSH-Px、SOD水平高于常规组,差异有统计学意义(P<0.05)。治疗28 d后两组血清ACTA、GFAP、HMGB1水平较治疗前降低,NBNA评分较治疗前升高,且观察组血清ACTA、GFAP、HMGB1水平低于常规组,NBNA评分高于常规组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,治疗前与治疗28 d后观察组血清ACTA、GFAP、HMGB1水平差值与NBNA评分差值均呈正相关(r=0.668、0.727、0.633,P<0.05)。结论亚低温治疗新生儿HIE效果显著,可有效改善患儿症状,减轻机体炎症、氧化应激损伤及大脑神经功能损伤,且治疗前后ACTA、GFAP、HObjective To investigate the changes of serum levels of endogenous activin A(ACTA),glial fibrillary acidic protein(GFAP)and high mobility group protein B1(HMGB1)before and after mild hypothermia treatment of neonatal hypoxic-ischemic encephalopathy(HIE)and their relationship with neonatal behavioral neurological assessment(NBNA)scores.Methods A total of 84 neonates with HIE admitted to the hospital from January 2018 to December 2021 were retrospectively selected as the research objects.According to different treatment methods,they were divided into observation group and conventional group,with 42 cases in each group.The conventional group was treated with conventional therapy,and the observation group was treated with mild hypothermia on the basis of conventional therapy.The efficacy,symptom improvement/recovery time,inflammatory factors[interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)],oxidative stress indicators[superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),malondialdehyde(MDA)],serum ACTA,GFAP,HMGB1 levels and NBNA scores before treatment and 28 d after treatment were compared between the two groups.The correlation between the difference of serum ACTA,GFAP,HMGB1 levels and NBNA score in the observation group before treatment and 28 d after treatment was analyzed.Results The total effective rate of the observation group was 95.24%,which was higher than that of the conventional group(78.57%),and the difference was statistically significant(P<0.05).The recovery time of muscle tension,consciousness and reflex and the improvement time of convulsion in the observation group were shorter than those in the conventional group,and the differences were statistically significant(P<0.05).After 28 d of treatment,the serum levels of IL-1β,IL-6 and TNF-αin the two groups were lower than those before treatment,and the observation group was lower than the conventional group,and the differences were statistically significant(P<0.05).After 28 d of treatment,the levels of serum GSH-Px and S

关 键 词：新生儿 缺血缺氧性脑病 内源性激活素A 亚低温治疗 高迁移率族蛋白B1 行为神经测定 胶质纤维酸性蛋白 

分 类 号：R747.9[医药卫生—神经病学与精神病学]