高胆红素血症新生儿血清G6PD、IGF-1水平与病情程度及听力损伤程度的关系  

Relationship between serum G6PD and IGF-1 levels with the severity of the disease and hearing loss in newborns with hyperbilirubinemia

作　　者：邓佳平 罗汉清 汪茹 施芬 Deng Jiaping;Luo Hanqing;Wang Ru;Shi Fen(Department of Pediatric Medicine,Xinzhou District People's Hospital,Hubei Province,Wuhan 431400,China)

机构地区：[1]武汉市新洲区人民医院小儿内科,431400

出　　处：《疑难病杂志》2024年第8期976-980,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：武汉市卫生健康委医疗卫生科研项目(WX17C28)。

摘　　要：目的分析高胆红素血症新生儿血清葡萄糖-6-磷酸脱氢酶(G6PD)、胰岛素样生长因子-1(IGF-1)水平与病情程度及听力损伤程度的关系。方法选取2022年12月—2023年12月武汉市新洲区人民医院小儿内科收治的高胆红素血症新生儿102例的临床资料,根据病情严重程度分为轻症组(n=41)、中症组(n=33)和重症组(n=28),采用ELISA法检测血清G6PD、IGF-1水平,采用Pearson法分析血清G6PD、IGF-1水平与患儿胆红素水平以及听力阈值之间的相关性;采用Logistic回归分析患儿听力损伤程度的影响因素;绘制受试者工作特征(ROC)曲线分析G6PD、IGF-1对患儿听力损伤程度的诊断价值。结果高胆红素血症中/重症组患儿的G6PD、IGF-1水平较轻症组患儿均显著降低(F/P=51.881/<0.001,42.334/<0.001),听力损伤中、重度亚组患儿的血清G6PD、IGF-1水平较轻度亚组显著降低(F/P=26.243/<0.001,22.454/<0.001);G6PD、IGF-1与患儿胆红素水平以及听力阈值均呈负相关(G6PD:r/P=-0.421/<0.001,-0.405/<0.001;IGF-1:r/P=-0.437/<0.001,-0.422/<0.001);血清G6PD、IGF-1及二者联合诊断患儿听力损伤程度的AUC分别为0.780、0.800、0.884,二者联合优于各自单独诊断价值(Z=2.905、2.109,P=0.004、0.035);胆红素、UCB升高是患儿听力损伤程度的独立危险因素[OR(95%CI)=1.354(1.111~1.650),1.157(1.022~1.309)],G6PD、IGF-1升高为患儿听力损伤程度的独立保护因素[OR(95%CI)=0.864(0.773~0.966),0.864(0.773~0.966)]。结论在高胆红素血症新生儿中,血清G6PD、IGF-1水平随病情程度加重显著降低,且两者对患儿听力损伤程度具有辅助诊断价值,是患儿听力损伤程度的影响因素。Objective To explore and analyze the relationship between serum levels of glucose-6-phosphate dehydrogenase(G6PD)and insulin-like growth factor-1(IGF-1)with the severity of disease and hearing loss in neonates with hyperbilirubinemia.Methods Clinical data of 102 newborns with high bilirubin admitted to Department of Pediatric Medicine,Xinzhou District People's Hospital from December 2022 to December 2023 were collected and assigned into mild group(n=41),moderate group(n=33),and severe group(n=28)based on the severity of their condition.Serum G6PD and IGF-1 levels were detected using ELISA,the general clinical data of the children were collected,receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of G6PD and IGF-1 in assessing the degree of hearing loss of the patient's condition,Logistic was applied to analyze the factors influencing the degree of hearing loss in children,Pearson method was applied to analyze the correlation between serum G6PD,IGF-1 levels,bilirubin level,and hearing thresholds in children.Results The levels of G6PD and IGF-1 in the moderate and severe groups were obviously lower than those in the mild group(F/P=51.881/<0.001,42.334/<0.001);the serum G6PD and IGF-1 levels of children in the moderate and severe subgroups were obviously lower than those in the mild subgroup(F/P=26.243/<0.001,22.454/<0.001),G6PD and IGF-1 were negatively correlated with bilirubin level and hearing thresholds in children(G6PD:r/P=-0.421/<0.001,-0.405/<0.001,IGF-1:r/P=-0.437/<0.001,-0.422/<0.001);the AUC of serum G6PD,IGF-1,and their combination in the diagnosis of the degree of hearing loss of disease was 0.780,0.800,and 0.884,respectively,the combined diagnosis was obviously better than the individual diagnosis of G6PD and IGF-1(Z=2.905,2.109,P=0.004,0.035);Bilirubin and UCB were independent risk factors for the degree of hearing impairment in children[OR(95%CI)=1.354(1.111-1.650),1.157(1.022-1.309)],and G6PD and IGF-1 were independent protective factors for the degree of hearing

关 键 词：高胆红素血症 葡萄糖-6-磷酸脱氢酶 胰岛素样生长因子-1 病情程度 听力损伤 新生儿 

分 类 号：R722.1[医药卫生—儿科]