高胆红素血症新生儿S-100、B/A、IGF-1的表达水平及其预测光疗效果的价值  

Significance of expression of S-100,B/A,and IGF-1 in neonates with hyperbilirubinemia and its value in predicting the effect of phototherapy

作　　者：王倩菲 李萍 WANG Qian-fei;LI Ping(Department of Neonatology,People's Hospital of Xi'an City,Xi'an 710000,Shaanxi,CHINA)

机构地区：[1]西安市人民医院新生儿科,陕西西安710000

出　　处：《海南医学》2023年第3期360-364,共5页Hainan Medical Journal

基　　金：陕西省西安市科技计划医学项目(编号:20YXYJ0164)。

摘　　要：目的检测高胆红素血症新生儿S-100蛋白(S-100)、总胆红素与白蛋白比值(B/A)、胰岛素样生长因子-1(IGF-1)的表达水平,并探讨其预测光疗效果的价值。方法选取2019年1月至2021年5月在西安市人民医院新生儿科治疗的97例高胆红素血症新生儿作为观察组,同时选取健康新生儿100例作为对照组,比较两组受检者的S-100、B/A、IGF-1表达水平,同时比较观察组不同病情程度、光疗效果患儿的S-100、B/A、IGF-1表达水平,采用受试者工作特征(ROC)分析S-100、B/A、IGF-1预测光疗效果的价值。结果观察组患儿的血清S-100和B/A分别为(0.41±0.10)μg/L和0.50±0.13,明显高于对照组的(0.23±0.06)μg/L和0.19±0.07,而IGF-1为(30.03±8.41)ng/mL,明显低于对照组的(53.36±11.07)μg/mL,差异均有统计学意义(P<0.05);观察组中重度组患儿的血清S-100和B/A分别为(0.47±0.10)μg/L和0.62±0.13,明显高于轻中度组患儿的(0.39±0.12)μg/L和0.46±0.11,而IGF-1为(20.55±5.80)ng/mL,明显低于轻中度组患儿的(33.32±6.65)ng/mL,差异均有统计学意义(P<0.05);观察组中光疗反应敏感患儿的血清IGF-1为(32.28±6.68)ng/mL,明显高于不敏感患儿的(28.45±7.10)ng/mL,差异有统计学意义(P<0.05);观察组中光疗效果有效患儿的血清S-100和B/A分别为(0.37±0.12)μg/L和0.48±0.11,明显低于无效患儿的(0.60±0.13)μg/L和0.59±0.12,而IGF-1为(32.24±5.57)ng/mL,明显高于无效患儿的(19.63±4.41)ng/mL,差异均有统计学意义(P<0.05);IGF-1预测光疗反应敏感的ROC曲线下面积为0.625,灵敏性和特异性分别为68.00%和67.00%;S-100、B/A、IGF-1预测光疗效果有效的ROC曲线下面积分别为0.864、0.733和0.773,灵敏性分别为64.00%、82.00%和68.00%,特异性分别为92.00%、61.00%和78.00%。结论高胆红素血症新生儿血清S-100和B/A升高,而IGF-1水平下降,与患儿病情程度、光疗效果有一定相关性,值得进一步研究。Objective To investigate the expression of S-100 protein(S-100),the ratio of total bilirubin to al-bumin(B/A),and insulin-like growth factor-1(IGF-1)in neonates with hyperbilirubinemia and its value in predicting the effect of phototherapy.Methods Ninety-seven newborns with hyperbilirubinemia treated in People's Hospital of Xi'an City from January 2019 to May 2021 were selected(observation group).At the same time,100 healthy newborns were selected as the control group.The levels of S-100,B/A,and IGF-1 were compared between the two groups,and also among children with disease severity,different phototherapy effects in the observation group.Receiver operating characteristic(ROC)curve was used to analyze the value of S-100,B/A,IGF-1 to predict the effect of phototherapy.Results The serum S-100 and B/A in the observation group were(0.41±0.10)μg/L and 0.50±0.13,respectively,which were significantly higher than(0.23±0.06)μg/L and 0.19±0.07 in the control group(P<0.05),while IGF-1 was(30.03±8.41)ng/mL,which was significantly lower than(53.36±11.07)ng/mL in the control group(P<0.05).The se-rum S-100 and B/A of severe children in the observation group were(0.47±0.10)μg/L and 0.62±0.13,respectively,which were significantly higher than(0.39±0.12)μg/L and 0.46±0.11 of mild and moderate children(P<0.05),while IGF-1 was(20.55±5.80)ng/mL,which was significantly lower than(33.32±6.65)ng/mL of mild and moderate chil-dren(P<0.05).The serum IGF-1 of sensitive children in the observation group was(32.28±6.68)ng/mL,which was significantly higher than(28.45±7.10)ng/mL in the insensitive children in the observation group(P<0.05).In the ob-servation group,the serum S-100 and B/A of effective children were(0.37±0.12)μg/L and 0.48±0.11,respectively,which were significantly lower than(0.60±0.13)μg/L and 0.59±0.12 of ineffective children(P<0.05),while IGF-1 was(32.24±5.57)ng/mL,which was significantly higher than(19.63±4.41)ng/mL of ineffective children(P<0.05).The area under ROC curve of IGF-1 in predicting phototh

关 键 词：高胆红素血症 S-100蛋白 总胆红素与白蛋白比值 胰岛素样生长因子-1 新生儿 光疗 

分 类 号：R722.19[医药卫生—儿科]