血清sLOX-1、VILIP-1和脑红蛋白在新生儿缺氧缺血性脑病病情和预后判断中的价值  

Value of serum sLOX-1,VILIP-1 and neuroglobin in judgment of condition and prognosis in neonatal hypoxic-ischemic encephalopathy

作　　者：宋奕 肖蕾萍 张嘉玲 SONG Yi;XIAO Leiping;ZHANG Jialing(Department of Neonatal Intensive Care Unit,Affiliated Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200090,China)

机构地区：[1]复旦大学附属妇产科医院新生儿重症监护室,上海200090

出　　处：《检验医学与临床》2023年第1期67-71,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨血清可溶性血凝素样氧化低密度脂蛋白受体-1(sLOX-1)、视锥蛋白样蛋白-1(VILIP-1)和脑红蛋白在新生儿缺氧缺血性脑病病情和预后判断中的临床价值。方法选择2019年1月至2021年12月该院收治的135例新生儿缺氧缺血性脑病患儿纳入观察组。选择同期在该院体检的75例健康足月新生儿纳入对照组。观察两组血清sLOX-1、VILIP-1和脑红蛋白水平变化,分析血清sLOX-1、VILIP-1和脑红蛋白水平与新生儿缺氧缺血性脑病严重程度的关系,对临床指标与患儿预后的关系进行单因素和多因素分析,探讨血清sLOX-1、VILIP-1和脑红蛋白预测患儿发生预后不良的价值。结果观察组的血清sLOX-1、VILIP-1和脑红蛋白水平明显高于对照组(P<0.01)。血清sLOX-1、VILIP-1和脑红蛋白水平随着疾病严重程度的升高而升高(P<0.01)。新生儿缺氧缺血性脑病患儿的预后不良与Apgar评分、开始治疗日龄、sLOX-1、VILIP-1和脑红蛋白水平有关(P<0.01),而与性别、孕周、日龄、胎龄、生产方式、出生时体质量、体温、心率、脐带异常,以及母体贫血、妊娠期糖尿病和妊娠期高血压无关(P>0.05)。多因素分析发现,血清sLOX-1>888.02 ng/L、VILIP-1>0.83μg/L和脑红蛋白>24.22 pg/mL是新生儿缺氧缺血性脑病患儿预后不良的独立危险因素(P<0.01)。血清sLOX-1、VILIP-1和脑红蛋白水平在预测新生儿缺氧缺血性脑病预后不良方面具有较高的价值,联合检测的灵敏度为96.9%,特异度为86.4%,曲线下面积(AUC)为0.971,明显高于sLOX-1(Z=2.289,P=0.022)、VILIP-1(Z=2.635,P=0.008)和脑红蛋白(Z=3.263,P=0.001)单项指标检测,而3项指标之间的AUC差异无统计学意义(P>0.05)。结论血清sLOX-1、VILIP-1和脑红蛋白水平与新生儿缺氧缺血性脑病的严重程度有密切联系,是患儿预后不良的独立危险因素,在预测预后不良方面具有较高的效能。Objective To investigate the value of serum soluble lectin-like oxidized low-density lipoprotein receptor-1(sLOX-1),visinin-like protein-1(VILIP-1)and neuroglobin in the judgment of the condition and prognosis in neonatal hypoxic-ischemic encephalopathy.Methods A total of 135 children patients with neonatal hypoxic-ischemic encephalopathy treated in this hospital from January 2019 to December 2021 were selected and included into the observation group.Seventy-five healthy full-term neonates undergoing physical examination in this hospital during the same period were included into the control group.The changes of serum sLOX-1,VILIP-1 and neuroglobin levels were observed in the two groups,and their relationship with the severity of hypoxic-ischemic encephalopathy was analyzed.The relationship between the clinical indicators and prognosis of the neonatal patients conducted the univariate and multivariate analysis.The value of serum sLOX-1,VILIP-1 and neuroglobin for predicting the poor prognosis occurrence was investigated.Results The serum sLOX-1,VILIP-1 and neuroglobin levels in the observation group were significantly higher than those in the control group(P<0.01).The serum sLOX-1,VILIP-1 and neuroglobin levels were increased with the severity increase(P<0.01).The poor prognosis of the patients with neonatal hypoxic-ischemic encephalopathy was related to the Apgar score,day age at treatment start and the levels of sLOX-1,VILIP-1 and neuroglobin(P<0.01),while had no relation with the gender,gestational week,day age,gestational week,mode of production,birth weight,body temperature,heart rate,abnormal umbilical cord,maternal anemia,gestational diabetes and gestational hypertension(P>0.05).The multivariate analysis found that serum sLOX-1>888.02 ng/L,VILIP-1>0.83μg/L and neuroglobin>24.22 pg/mL were the independent risk factors for poor prognosis in the neonates with hypoxic-ischemic encephalopathy(P<0.05).The serum sLOX-1,VILIP-1 and neuroglobin levels had high value in predicting poor prognosis of neonatal hypoxic-

关 键 词：可溶性血凝素样氧化低密度脂蛋白受体-1 视锥蛋白样蛋白-1 脑红蛋白 新生儿缺氧缺血性脑病 

分 类 号：R722.1[医药卫生—儿科]