血清NSE、NGB水平与新生儿缺氧缺血性脑病严重程度的相关性及对预后的预测价值研究  

Correlation Between Serum NSE and NGB Levels and the Severity of Neonatal Hypoxic Ischemic Encephalopathy and Their Prognostic Value

作　　者：马会强 Ma Huiqiang(Department of Neonatology,Kaifeng Maternity and Obstetrics Hospital,Kaifeng,Henan,475000,China)

机构地区：[1]开封市妇产医院新生儿科,河南开封475000

出　　处：《黑龙江医学》2024年第8期919-922,共4页Heilongjiang Medical Journal

摘　　要：目的:研究血清神经元特异性烯醇化酶(NSE)、脑红蛋白(NGB)水平与新生儿缺氧缺血性脑病(HIE)严重程度的相关性及对预后的预测价值,为临床提供参考。方法:选取2015年6月—2021年6月开封市妇产医院收治的152例HIE患儿作为研究对象,将其设为疾病组。另选取同期于开封市妇产医院出生的健康新生儿50例,将其设为正常组。比较两组新生儿血清NSE、NGB水平。根据病情严重程度分疾病组为轻度组(48例)、中度组(59例)、重度组(45例)。比较三组患儿血清NSE、NGB水平。采用Spearman相关性分析法分析血清NSE、NGB与HIE严重程度的相关性。随访6个月,根据患儿预后情况将其分为良好组(115例)、不良组(33例),采用logistic回归分析HIE预后不良的危险因素。绘制新生儿工作特征曲线(ROC),分析血清NSE、NGB对HIE预后不良的预测价值。结果:疾病组血清NSE、NGB水平高于正常组,差异有统计学意义(t=31.041、43.497,P<0.05)。中、重度组血清NSE、NGB水平高于轻度组,重度组血清NSE、NGB水平高于中度组,差异有统计学意义(F=191.507、143.945,P<0.05)。Spearman相关性分析结果显示,血清NSE、NGB水平与HIE严重程度呈正相关(r=0.853、0.830,P<0.05)。logistic回归分析结果显示,5 min Apgar评分≤7分、HIE严重程度为重度、发病至治疗时间≥48 h是HIE预后不良的危险因素,差异有统计学意义(OR=3.149、3.677、1.865、2.396、5.726,P<0.05)。ROC显示,血清NSE、NGB预测HIE预后不良的最佳截断点分别为33.05 ng/mL、203.09 pg/mL,单独及联合预测的ROC下面积(AUC)分别为0.784、0.821、0.890,两者联合检测的预测价值高于单独检测。结论:血清NSE、NGB水平与新生儿HIE严重程度呈正相关,且两者联合检测对该病预后具有较高的预测价值。Objective:To study the correlation between serum neuron-specific enolase(NSE)and neuroglobin(NGB)levels and the severity of neonatal ischemic hypoxic encephalopathy(HIE)and its prognostic value.Methods:A total of 152 children with HIE in the hospital from June 2015 to June 2021 were selected and assigned to the disease group,and they were divided into mild group(48 cases),moderate group(59 cases),and severe group(45 cases)according to the severity of their illness.The levels of serum NSE and NGB were compared between the disease group and the normal group.The levels of serum NSE and NGB were compared between the mild group,moderate group and severe group.Spearman correlation analysis method was used to analyze the correlation between the two and the severity of HIE.After 6 months,the prognosis was calculated,and the children were divided into good group(115 cases)and bad group(33 cases).Logistic regression analysis was used to analyze the risk factors of poor prognosis of HIE.The newborn operating characteristic curve(ROC)was drawed to analyze the predictive value of serum NSE and NGB for poor prognosis of HIE.Results:The levels of serum NSE and NGB in the disease group were higher than those in the normal group,and the difference was statistically significant(t=31.041,43.497;P<0.05).Serum NSE and NGB levels in the severe group were higher than those in the moderate group,and the difference was statistically significant(F=191.507,143.945;P<0.05).Spearman correlation analysis showed that serum NSE and NGB level were positively correlated with HIE severity(r=0.853,0.830;P<0.05).Logistic regression analysis showed that 5 min Apgar score≤7,severity of HIE,onset to treatment time≥48 h are the risk factors for poor prognosis of HIE,and the differences are statistically significant(OR=3.149,3.677,1.865,2.396,5.726;P<0.05).The ROC curve Showed that the best cut-off points of serum NSE and NGB for predicting poor prognosis of HIE were 33.05 ng/mL and 203.09 pg/mL,respectively,and the AUC of individual and combined pre

关 键 词：缺氧缺血性脑病 神经元特异性烯醇化酶 脑红蛋白 

分 类 号：R722.1[医药卫生—儿科]