血清HO-1、脑红蛋白和NPY对新生儿黄疸患儿发生脑损伤的诊断价值  

Diagnostic value of serum HO-1,neuroglobin and NPY on brain injury in neonatal jaundice

作　　者：肖蕾萍 周鼎 宋奕 XIAO Leiping;ZHOU Ding;SONG Yi(Department of Neonatology,Obstetrics and Gynecology Hospital Affiliated to Fudan University,Shanghai 200090,China)

机构地区：[1]复旦大学附属妇产科医院新生儿科,上海200090

出　　处：《检验医学与临床》2023年第3期370-373,378,共5页Laboratory Medicine and Clinic

摘　　要：目的观察血清血红素氧化酶(HO)-1、脑红蛋白和神经肽Y(NPY)检测对新生儿黄疸患儿发生脑损伤的诊断价值。方法选择2019年1月至2021年12月在该院诊治的新生儿黄疸患儿216例作为黄疸组,同时根据黄疸的严重程度将其分为轻度组(99例)、中度组(85例)和重度组(32例),根据脑部诊断结果分为无脑损伤组(192例)和脑损伤组(24例);另选取同期在该院出生的健康新生儿55例作为对照组。观察黄疸组患儿治疗前后血清HO-1、脑红蛋白和NPY的水平变化并与对照组进行比较,探讨血清HO-1、脑红蛋白和NPY水平与新生儿黄疸严重程度和脑损伤的关系,以及其对新生儿黄疸患儿脑损伤的诊断效能。结果治疗前黄疸组血清HO-1、脑红蛋白和NPY水平明显高于对照组(P<0.05),治疗后黄疸组血清HO-1、脑红蛋白和NPY水平较治疗前明显降低(P<0.05)。血清HO-1、脑红蛋白和NPY水平明随着新生儿黄疸严重程度的升高而升高(P<0.05)。脑损伤组血清HO-1、脑红蛋白和NPY水平明显高于无脑损伤组(P<0.05)。血清HO-1、脑红蛋白和NPY对新生儿黄疸患儿脑损伤具有较高的诊断效能,三者联合检测灵敏度为95.8%,特异度为94.8%,曲线下面积(AUC)为0.966,明显高于HO-1、脑红蛋白、NPY单独检测(P<0.05),而3个指标之间的AUC比较,差异无统计学意义(P>0.05)。新生儿黄疸患儿血清HO-1水平与脑红蛋白、NPY呈正相关(r=0.766、0.875,P<0.05),血清脑红蛋白水平和NPY呈正相关(r=0.832,P<0.05)。结论血清HO-1、脑红蛋白和NPY水平是判断新生儿黄疸严重程度的指标,三者联合检测有助于提高对新生儿黄疸患儿脑损伤的诊断效能。Objective To observe the diagnostic value of serum heme oxidase(HO)-1,neuroglobin and neuropeptide Y(NPY)on brain injury in children with neonatal jaundice.Methods From January 2019 to December 2021,216 neonates with jaundice diagnosed and treated in Obstetrics and Gynecology Hospital Affiliated to Fudan University were selected as the jaundice group,who were divided into mild group(99 cases),medium group(85 cases)and severe group(32 cases)according to the severity of jaundice,brain injury group(192 cases)and the group without brain injury(24 cases)according to the brain CT/MRI diagnosis.Meanwhile 55 healthy neonates in the same hospital during the same period were selected as the control group.The serum levels of HO-1,neuroglobin and NPY in patients with neonatal jaundice were observed before and after treatment,and compared with the control group.To analyze the relationship between the serum HO-1,neuroglobin,NPY and the severity of neonatal jaundice and brain damage,and to explore the diagnotic efficacy of serum HO-1,neuroglobin and NPY on brain injury in children with neonatal jaundice.Results Before treatment,the serum levels of HO-1,neuroglobin and NPY in the jaundice group were significantly higher than those in the control group(P<0.05).The serum levels of HO-1,neuroglobin and NPY in the jaundice group after treatment were obviously lower than those before treatment(P<0.05).The serum levels of HO-1,neuroglobin and NPY increased with the severity of neonatal jaundice(P<0.05).The serum levels of HO-1,neuroglobin and NPY in the brain injury group were significantly higher than those in the group without brain injury(P<0.05).The serum HO-1,neuroglobin and NPY levels had high diagnostic efficacy in predicting neonatal brain injury,the sensitivity of combined detection was 95.8%,the specificity was 94.85%,and the AUC was 0.966,which was significantly higher than the single detection of HO-1,neuroglobin and NPY(P<0.005),while there was no significant difference in AUC among the above three indicators(P>0.05).The

关 键 词：血红素氧化酶-1 脑红蛋白 神经肽Y 新生儿黄疸 脑损伤 

分 类 号：R722.17[医药卫生—儿科]