新生儿缺血缺氧性脑病血清中HIF-1α表达水平与病情严重程度及预后的相关性研究  

Study on association between serum HIF-1αexpression level and severity and prognosis of neonatal hypoxic-ischemic encephalopathy

作　　者：焦红梅 刘雨露[1] 李欣 王战胜[1] Jiao Hongmei;Liu Yulu;Li Xin;Wang Zhansheng(Department of NICU,Shangqiu First People's Hospital,Shangqiu,Henan 476000,China)

机构地区：[1]商丘市第一人民医院新生儿重症监护室,河南商丘476000

出　　处：《齐齐哈尔医学院学报》2024年第16期1556-1559,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨新生儿缺血缺氧性脑病(NHIE)血清中HIF-1α表达水平及其临床意义。方法选择2021年2—12月在本院新生儿科诊断为NHIE的150例患儿(NHIE组)和同期75名健康新生儿(对照组)作为研究对象。血清中HIF-1α表达水平采用ELISA法检测。NHIE根据病情严重程度分为轻度、中度和重度三组亚组。根据NHIE患儿随访结果并分为预后不良组(n=39)和预后良好组(n=111)。Logistic回归分析NHIE患儿预后不良的危险因素,HIF-1α在预测NHIE患儿出现预后不良的临床效能采用ROC曲线分析。结果对照组和NHIE组血清中HIF-1α的表达水平分别为(34.12±4.34)mg/ml和(71.23±5.98)mg/ml,与对照组相比,HIF-1α的表达水平在NHIE组中显著升高,差异有统计学意义(t=46.794,P<0.001)。轻度、中度和重度NHIE患儿HIF-1α的表达水平分别为(45.03±4.38)mg/ml、(60.42±6.07)mg/ml和(79.97±5.41)mg/ml,三组间比较存在显著差异(F=45.123,P<0.001);HIF-1α的表达水平在轻度、中度和重度中依次升高,两两比较均存在明显差异(P<0.05)。与预后良好组相比,病情严重程度为中、重度比例、hs-CRP及HIF-1α水平在预后不良组中显著升高,而Apgar评分在预后不良组中明显降低,差异均具有统计学意义(P<0.05)。Logistic回归分析结果显示,病情严重程度(OR=2.232)、hs-CRP(OR=3.893)和HIF-1α(OR=4.937)是NHIE患儿发生预后不良的独立危险因素。ROC曲线结果显示,HIF-1α在预测NHIE患儿出现预后不良的AUC为0.911,诊断敏感度和特异度为92.25%和96.18%,HIF-1α截断值为70.15 mg/ml。结论NHIE患儿血清中HIF-1α表达水平显著升高,HIF-1α可作为NHIE患者预后不良的一项生物学标志物。Objective To investigate the serum expression level of HIF-1αin neonatal hypoxic-ischemic encephalopathy(NHIE)and its clinical significance.Methods A total of 150 neonates with NHIE(NHIE group)who were diagnosed in NICU of our hospital from February to December,2021,and 75 healthy neonates(control group)during the same period were included in this study.The serum expression level of HIF-1αin all individuals were detected by ELISA methods.All patients with NHIE were divided into mild,moderate and severe groups according to the severity of NHIE.Besides,all NHIE were divided into a poor prognosis group(n=39)and a good prognosis group(n=111)according to the follow-up conditions.The Logistic regression was used to analyze the risk factors of poor prognosis of NHIE.The clinical efficacy of HIF-1αin predicting the incidence of poor prognosis in NHIE was analyzed by ROC curve.Results The serum expression level of HIF-1αin control and NHIE group was(34.12±4.34)mg/mL and(71.23±5.98)mg/mL,respectively.Compared with the control group,the serum expression level of HIF-1αin NHIE group was significantly increased,and the difference was statistically significant(t=46.794,P<0.001).The serum expression level of HIF-1αin mild,moderate and severe groups were(45.03±4.38)mg/mL,(60.42±6.07)mg/mL and(79.97±5.41)mg/mL,respectively,and there was a significant difference among the three groups(F=45.123,P<0.001).The serum expression level of HIF-1αwas increased in mild,moderate and severe group in sequence,and there was a significant difference in pairwise comparison(P<0.05).Compared with the good prognosis group,the proportion of moderate to severe disease severity,hs-CRP and HIF-1αlevels were significantly increased in poor prognosis group,while the Apgar score was significantly decreased,with a statistical significance(P<0.05).Logistic regression analysis showed that disease severity(OR=2.232),hs-CRP(OR=3.893)and HIF-1α(OR=4.937)were independent risk factors for poor prognosis in NHIE.The ROC curve results showed that the A

关 键 词：缺血缺氧性脑病 缺氧诱导因子-1Α 病情严重程度 预后 

分 类 号：R722.1[医药卫生—儿科]