血清NSE、维生素K_(1)与SIRS新生儿病情严重程度的相关性及对凝血功能异常的评估价值  

Correlation of Serum NSE and Vitamin K_(1) with Severity of SIRS Neonates and Their Evaluation Value for Abnormal Coagulation Function

作　　者：袁二伟[1] 曲海新[1] 许津莉[1] 张雅静[1] 王瑞娟[1] 郭华贤[1] YUAN Erwei;QU Haixin;XU Jinli;ZHANG Yajing;WANG Ruijuan;GUO Huaxian(Department of Neonatology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院新生儿科,河北张家口075000

出　　处：《医学综述》2023年第21期4784-4789,共6页Medical Recapitulate

基　　金：张家口市重点研发计划项目(1921061D)。

摘　　要：目的研究血清神经元特异性烯醇化酶(NSE)、维生素K_(1)与全身炎症反应综合征(SIRS)新生儿病情严重程度的相关性及对凝血功能异常的评估价值。方法选取2019年1月至2021年12月河北北方学院附属第一医院收治的147例SIRS新生儿为研究对象(研究组),另选取80例同期足月健康新生儿为对照组。根据SIRS新生儿病情严重程度,将研究组分为非危重组(60例)、危重组(48例)和极危重组(39例),检测所有患儿的血清NSE、维生素K_(1)水平。采用Spearman相关性分析分析血清NSE、维生素K_(1)水平与SIRS新生儿病情严重程度的相关性。同时,根据患儿凝血功能是否正常将研究组分为正常组(43例)和异常组(104例),采用单因素分析影响SIRS新生儿凝血功能异常的相关因素,Logistic回归分析影响SIRS新生儿凝血功能异常的危险因素,并绘制受试者工作特征曲线(ROC曲线)分析血清NSE、维生素K_(1)水平对SIRS新生儿凝血功能异常的评估价值。结果研究组患儿的血清NSE水平高于对照组[(34.0±4.6)μg/L比(15.5±3.2)μg/L](P<0.01),血清维生素K_(1)水平低于对照组[(0.14±0.04)μg/L比(0.26±0.06)μg/L](P<0.01)。非危重组、危重组、极危重组的血清NSE、维生素K_(1)水平比较差异有统计学意义(P<0.01);与非危重组相比,极危重组和危重组患儿的血清NSE水平升高[(43.9±3.4)μg/L、(35.6±4.2)μg/L比(26.4±3.3)μg/L](P<0.05),且极危重组高于危重组(P<0.05);与非危重组比较,极危重组和危重组患儿的血清维生素K_(1)水平降低[(0.078±0.021)μg/L、(0.145±0.031)μg/L比(0.183±0.042)μg/L](P<0.05),且极危重组低于危重组(P<0.05)。Spearman相关性分析显示,血清NSE水平与SIRS新生儿病情严重程度呈正相关(r=0.523,P<0.001),血清维生素K_(1)水平与SIRS新生儿病情严重程度呈负相关(r=-0.489,P<0.001)。凝血功能异常组胎膜早破、小于胎龄儿、剖宫产、出生窒息占比和血清NSE水平高于凝血功Objective To study the correlation of serum neuron specific enolase(NSE),vitamin K_(1) with the severity of systemic inflammatory response syndrome(SIRS)in newborns,and the evaluation value for coagulation dysfunction.Methods A total of 147 neonates with SIRS admitted to the First Affiliated Hospital of Hebei North University from Jan.2019 to Dec.2021 were included as a study group,and 80 healthy full-term neonates during the same period were included as a control group.The study group was divided into a non-critical group(n=60),a critical group(n=48)and an extremely critical group(n=39)according to the severity of neonatal illness,and the serum NSE and vitamin K_(1) levels of all subjects were detected.Spearman correlation analysis was used to analyze the correlation of serum NSE and vitamin K_(1) levels with the severity of neonatal disease.At the same time,the study group was divided into a normal group(n=43)and an abnormal group(n=104)according to whether the coagulation function of the children was normal or not.Univariate analysis was adopted to analyze related factors affecting coagulation dysfunction in neonates with SIRS.Logistic regression analysis was performed to analyze the risk factors for abnormal blood coagulation in neonates with SIRS,and receiver operating characteristic(ROC)curves were drawn to evaluate the value of serum NSE and vitamin K_(1) levels in evaluating the abnormal coagulation in neonates with SIRS.Results The serum NSE level in the study group was higher than that in the control group[(34.0±4.6)μg/L vs(15.5±3.2)μg/L](P<0.01).Serum vitamin K_(1) level was lower than that of the control group[(0.14±0.04)μg/L vs(0.26±0.06)μg/L](P<0.01).The serum levels of NSE and vitamin K_(1) were significantly different among the non-critical group,critical group and extremely critical group(P<0.01).Among them,compared with the non-critical group,the serum NSE level in the extremely critical group and the critical group was increased[(43.9±3.4)μg/L,(35.6±4.2)μg/L vs(26.4±3.3)μg/L](P<0.

关 键 词：全身炎症反应综合征 新生儿 神经元特异性烯醇化酶 维生素K_(1) 病情严重程度 凝血功能 

分 类 号：R725.9[医药卫生—儿科]