血清ACTA、LXA4、Tau蛋白在HIE患儿预后评估中的价值  

Roles of serum ACTA,LXA4,Tau protein in prognostic evaluation of children with hypoxic-ischemic encephalopathy

作　　者：赵倩[1] 胡红霞[1] ZHAO Qian;HU Hongxia(Department of Clinical Laboratory,the First Affiliated Hospital of Zhengzhou University,Key Clinical Laboratory of Henan Province,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学第一附属医院检验科河南省检验医学重点实验室,河南郑州450000

出　　处：《检验医学》2022年第11期1057-1061,共5页Laboratory Medicine

摘　　要：目的探讨缺氧缺血性脑病(HIE)患儿激活素A(ACTA)、脂氧素A4(LXA4)、Tau蛋白表达与新生儿神经行为测定(NBNA)评分、炎症反应的关系,分析各项指标在HIE患儿预后判断中的价值。方法选取HIE患儿145例,根据治疗后是否存活分为存活组(118例)和死亡组(27例),收集所有患儿的临床资料,检测治疗前血清ACTA、LXA4、Tau蛋白、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和高迁移率族蛋白B1(HMGB1)水平。采用Pearson相关分析评估各项指标之间的相关性。采用Logistic回归分析评估血清ACTA、LXA4、Tau蛋白与死亡的关系。采用受试者工作特征(ROC)曲线评估各项指标单项检测和联合检测判断HIE预后的效能。结果死亡组血清ACTA、Tau蛋白、IL-6、TNF-α、HMGB1水平均高于存活组(P<0.05),血清LXA4水平低于存活组(P<0.05)。Pearson相关分析结果显示,血清ACTA、Tau蛋白与血清IL-6、TNF-α、HMGB1均呈正相关(P<0.05),与NBNA评分呈负相关(P<0.05);LXA4与NBNA评分呈正相关(P<0.05),与血清IL-6、TNF-α、HMGB1均呈负相关(P<0.05)。血清ACTA、LXA4、Tau蛋白是HIE患儿死亡的影响因素[比值比(OR)分别为6.133、0.547、8.260,95%可信区间(CI)分别为4.126~9.115、0.347~0.862、4.803~14.206]。ROC曲线分析结果显示,血清ACTA、LXA4和Tau蛋白单项检测和联合检测模型判断HIE患儿预后的曲线下面积(AUC)分别为0.774、0.778、0.840和0.871。结论HIE患儿血清ACTA、Tau蛋、LXA4水平与NBNA评分、炎症反应密切相关,对患儿的预后评估有一定的价值。Objective To investigate the relationship between the expressions of activin A(ACTA),ATlipoxin A4(LXA4)and Tau protein in children with hypoxic-ischemic encephalopathy(HIE)with neonatal behavioral neurological assessment(NBNA)scores and inflammation,and to analyze the value of each index in predicting the risk of death in children.Methods Totally,145 children with HIE were enrolled and classified into survival group(118 cases)and death group(27 cases)according to the prognosis during hospitalization.The clinical data,serum levels of ACTA,LXA4,Tau protein,interleukin-6(IL-6),tumor necrosis factoralpha(TNF-α)and high mobility group protein box 1(HMGB1)were compared between the 2 groups.Pearson correlation analysis was used.Logistic regression analysis was used to analyze the correlations of ACTA,LXA4,Tau protein with death.Receiver operating characteristic(ROC)curve was used to evaluate the efficiency of single determinations and combined determination for evaluating the prognosis of HIE.Results In death group,serum ACTA,Tau protein,IL-6,TNF-α,HMGB1 level were higher than those in survival group,and LXA4 was lower than that in survival group(P<0.05).Serum ACTA and Tau protein were negatively correlated with NBNA scores(P<0.05),they were correlated positively with IL-6,TNF-αand HMGB1(P<0.05),serum LXA4 is positively correlated with NBNA scores(P<0.05),and it was negatively correlated with IL-6,TNF-αand HMGB1(P<0.05).Serum ACTA,LXA4 and Tau protein were influencing factors for the prognosis of HIE[odds ratios(OR)were 6.133,0.547 and 8.260,95%confidence intervals(CI)were 4.126-9.115,0.347-0.862 and 4.803-14.206](P<0.05).The areas under curves(AUC)of serum ACTA,LXA4 and Tau protein single determinations and combined determination in predicting the prognosis of children with HIE were 0.774,0.778,0.840 and 0.871,respectively.Conclusions Serum levels of ACTA,Tau protein and LXA4 in children with HIE were related to NBNA scores and inflammation,and they have certain predictive value for the prognosis of children.

关 键 词：激活素A 脂氧素A4 TAU蛋白 新生儿神经行为测定评分 炎症因子 缺氧缺血性脑病 

分 类 号：R446.1[医药卫生—诊断学]