缺血缺氧性脑病新生儿血清可溶性细胞间黏附分子1、肌酸激酶同工酶、胰岛素样生长因子1检测及其与病情严重程度和预后关系研究  

Serum sICAM-1,CK-MB,IGF-1 in neonates with hypoxic-ischemic encephalopathyand their relationship with disease severity and prognosis

作　　者：贺兰 王健 杜燕燕 HE Lan;WANG Jian;DU Yanyan(Department of Pediatrics,Beijing Tsinghua Changgung Hospital,Beijing 102218,China)

机构地区：[1]北京清华长庚医院儿科,北京102218

出　　处：《陕西医学杂志》2024年第12期1689-1692,1698,共5页Shaanxi Medical Journal

基　　金：北京市自然科学基金资助项目(2023FH1369)。

摘　　要：目的:探讨缺血缺氧性脑病(HIE)新生儿血清可溶性细胞间黏附分子1(sICAM-1)、肌酸激酶同工酶(CK-MB)、胰岛素样生长因子1(IGF-1)与病情严重程度及预后的关系。方法:选择HIE患儿125例为HIE组,另选择健康新生儿112例为对照组,比较两组血清sICAM-1、CK-MB、IGF-1水平。根据疾病严重程度将HIE患儿分为轻、中、重度组,分析HIE患儿血清sICAM-1、CK-MB、IGF-1水平与病情严重程度的相关性。根据随访结果将HIE患儿分为预后良好组和预后不良组,比较两组临床资料。Logistic回归分析HIE患儿预后不良的影响因素。结果:HIE组血清sICAM-1、CK-MB水平高于对照组,血清IGF-1水平低于对照组(均P<0.05)。HIE患儿血清sICAM-1、CK-MB水平随病情严重程度的增加而升高,IGF-1水平则随病情严重程度的增加而降低(均P<0.05)。预后不良组患儿病情重度占比、血清sICAM-1和CK-MB水平高于预后良好组,开始治疗日龄晚于预后良好组,Apgar评分和血清IGF-1水平低于预后良好组(均P<0.05)。HIE患儿预后危险因素包括开始治疗日龄>3 d、疾病重度、高水平sICAM-1和CK-MB、低水平IGF-1(均P<0.05)。HIE患儿疾病严重程度、开始治疗日龄与血清sICAM-1、CK-MB水平呈正相关,与血清IGF-1水平呈负相关(均P<0.05)。结论:HIE患儿血清sICAM-1、CK-MB水平升高,IGF-1水平下降。HIE患儿疾病严重程度与血清sICAM-1、CK-MB水平呈正相关,与IGF-1呈负相关。Objective:To investigate the serum soluble intercellular adhesion molecule-1(sICAM-1),creatine kinase isoenzyme(CK-MB),insulin-like growth factor 1(IGF-1)in neonatal with hypoxic-ischemic encephalopathy(HIE)and their relationship disease severity and prognosis.Methods:A total of 125 neonates with HIE were enrolled as the HIE group,and 112 healthy neonates were enrolled as the control group,and the serum levels of sICAM-1,CK-MB,and IGF-1 were compared between the two groups.The neonates with HIE were divided into mild,moderate,and severe groups according to the severity of the disease,and the correlations of serum levels of sICAM-1,CK-MB and IGF-1 with the severity of the disease were analyzed.According to the follow-up results,the HIE neonates were divided into good prognosis group and poor prognosis group,and the clinical data were compared between the two groups.Logistic regression was used to analyze the influencing factors for poor prognosis in neonates with HIE.Results:Serum sICAM-1 and CK-MB levels in HIE group were higher than those in control group,and serum IGF-1 levels was lower than those in control group(all P<0.05).The levels of sICAM-1 and CK-MB increased with the severity of HIE,while the level of IGF-1 decreased with the severity of HIE(all P<0.05).Compared with the good prognosis group,the poor prognosis group had a higher proportion of children with severe disease,higher serum sICAM-1 and CK-MB levels,a later age at the start of treatment,and a lower Apgar score and serum IGF-1 level(all P<0.05).The risk factors for prognosis in neonates with HIE included age>3 days at the beginning of treatment,severe disease,high levels of sICAM-1 and CK-MB,and low level of IGF-1(all P<0.05).The severity of HIE and the age at the beginning of treatment were positively correlated with the serum levels of sICAM-1 and CK-MB,and negatively correlated with the serum level of IGF-1(all P<0.05).Conclusion:The levels of serum sICAM-1 and CK-MB in HIE neonates increased,while IGF-1 decreased.The severity of disease in

关 键 词：缺血缺氧性脑病 可溶性细胞间黏附分子1 肌酸激酶同工酶 胰岛素样生长因子1 预后 影响因素 新生儿 

分 类 号：R722.1[医药卫生—儿科]