出 处:《中国实用神经疾病杂志》2022年第12期1501-1506,共6页Chinese Journal of Practical Nervous Diseases
摘 要:目的探讨缺氧缺血性脑病(HIE)新生儿血清髓鞘碱性蛋白(MBP)、高速泳动族蛋白B1(HMGB1)、白细胞介素23(IL-23)、细胞介素17(IL-17)水平的变化,并分析其与预后相关性。方法选取2021-01—2022-06安阳市人民医院儿科治疗的HIE患儿87例为研究组,根据病情严重程度分为轻度组41例,中度组27例和重度组19例,根据预后情况分为存活组65例和死亡组22例,选取同期健康新生儿87例为对照组。比较各组血清MBP、HMGB1、IL-23、IL-17水平,分析血清MBP、HMGB1、IL-23、IL-17水平对新生儿HIE预后的预测价值。结果研究组血清MBP、HMGB1、IL-23、IL-17水平明显高于对照组(P<0.05)。血清MBP、HMGB1、IL-23、IL-17水平比较,重度组>中度组>轻度组,差异均有统计学意义(P<0.05)。死亡组血清MBP、HMGB1、IL-23、IL-17水平明显高于存活组(P<0.05)。受试者工作特征(ROC)曲线分析显示,MBP、HMGB1、IL-23、IL-17、四者联合预测新生儿HIE预后的AUC分别为0.800、0.838、0.753、0.778、0.899,最佳截断值分别为1.85、7.95、100、65、4.2414,约登指数分别为0.447、0.604、0.500、0.508、0.755,在最佳截断值对应的敏感度、特异度:MBP分别为95.5%、49.2%,HMGB1分别为72.7%、87.7%,IL-23分别为50%、100%,IL-17分别为100%、50.8%,四者联合分别为90.9%、84.6%。结论HIE患儿血清MBP、HMGB1、IL-23、IL-17水平呈高表达,病情越严重,血清MBP、HMGB1、IL-23、IL-17水平越高。血清MBP、HMGB1、IL-23、IL-17水平联合对HIE患儿死亡具有较好的预测价值。Objective To investigate the changes of serum myelin basic protein(MBP),high-speed swimming group protein B1(HMGB1),interleukin-23(IL-23)and interleukin-17(IL-17)levels in neonates with hypoxic-ischemic encephalopathy(HIE),and analyze the correlation with prognosis.Methods From January 2021to June 2022,87 neonates with HIE diagnosed and treated in the Department of Pediatrics of Anyang People’s Hospital were selected as the study group.According to the severity of the disease,they were divided into mild group(41 cases),moderate group(27 cases)and severe group(19 cases).According to the prognosis,they were divided into survival group(65 cases)and death group(22 cases).Eighty-seven healthy neonates in the same period were selected as the control group.The serum MBP,HMGB1,IL-23,IL-17 levels in each group were compared,and the predictive value of serum MBP,HMGB1,IL-23,IL-17 levels on the prognosis of neonatal HIE was analyzed.Results Serum MBP,HMGB1,IL-23,IL-17 levels in the study group were significantly higher than those in the control group(P<0.05).The comparison of serum MBP,HMGB1,IL-23 and IL-17 levels in neonates with HIE:severe group>moderate group>mild group,with statistical significance(P<0.05).The serum MBP,HMGB1,IL-23 and IL-17 levels in the death group were significantly higher than those in the survival group(P<0.05).The analysis of ROC curve showed that the AUC of MBP,HMGB1,IL-23,IL-17 and their combination in predicting the prognosis of neonatal HIE were 0.800,0.838,0.753,0.778,0.899,the best cutoff values were 1.85,7.95,100,65,4.2414,and the Yodon index were 0.447,0.604,0.500,0.508,0.755,respectively.The sensitivity and specificity of MBP at the best cutoff values were 95.5%,49.2%,and HMGB1 were 72.7%,87.7%,IL-23 was 50%,100%,IL-17 was 100%,50.8%,and the combination of the four was 90.9%,84.6%.Conclusion The serum MBP,HMGB1,IL-23,IL-17 are highly expressed in neonates with HIE,and the more serious the condition is,the higher the serum MBP,HMGB1,IL-23,IL-17 levels are.The combination of serum MBP,HMG
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