基于中介效应分析苍白球/壳核灰度比值对高胆红素血症患儿神经肽Y与并发急性胆红素脑病的影响  

Analysis of the mediating effect of the globus pallidus to putamen gray ratio and neuropeptide Y on acute bilirubinencephalopathy complicating neonatal hyperbilirubinemia

作　　者：刘冰[1] 张兴旺 褚洪光[1] LIU Bing;ZHANG Xingwang;CHU Hongguang(Department of Ultrasound,Weifang Hospital of Traditional Chinese Medicine,Weifang,Shandong 261000,China)

机构地区：[1]潍坊市中医院超声科,山东潍坊261000

出　　处：《中国优生与遗传杂志》2024年第10期2112-2118,共7页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨高胆红素血症(HNB)患儿苍白球/壳核灰度比值与神经肽Y(NYP)对并发急性胆红素脑病(ABE)的影响。方法选取2022年1月至2023年2月于潍坊市中医院确诊的HNB患儿135例,分为HNB组(n=103)和合并ABE组(n=32)。多因素Logistic回归分析独立关联性,限制性立方样条分析剂量-反应关系,线性回归分析相关性,百分位Bootstrap法检验中介效应显著性。结果合并ABE组患儿苍白球/壳核灰度比值、NPY水平高于HNB组(P<0.05)。NPY水平和苍白球/壳核灰度比值是HNB患儿并发ABE的独立危险因素(P<0.05),临界值分别为5.47 ng/L和1.40。调整患儿年龄、性别、体质量后,NPY水平与苍白球/壳核灰度比值呈正相关。苍白球/壳核灰度比值部分介导NPY水平对HNB患儿并发ABE的影响,中介效应系数为0.183(95%CI:0.147~0.204)。结论NPY和苍白球/壳核灰度比值是HNB患儿并发ABE的危险因素,苍白球/壳核灰度比值部分介导了NPY对ABE的影响。Objective To investigate the effect of globus pallidus to putamen gray ratio and neuropeptide Y(NYP)on acute bilirubin encephalopathy(ABE)complicating neonatal hyperbilirubinemia(HNB).Methods From January 2022 to February 2023,135 children with HNB who diagnosed in Weifang Hospital of Traditional Chinese Medicine,which were divided into HNB group(n=103)and combined ABE group(n=32).Multifactorial logistic regression was used to analyse independent associations.Restricted cubic spline analysis of dose-response relationship.Linear regression to analyse correlation.Percentile Bootstrap method to test significance of mediating effects.Results Children in combined ABE group had a higher globus pallidus to putamen gray ratio and NPY levels than those in HNB group(P<0.05).The NPY level and globus pallidus to putamen gray ratio were independent risk factors for ABE in children with HNB(P<0.05),with critical values of 5.47 ng/L and 1.40.After adjusting for age,sex,and weight of the children,NPY level was positively correlated with the globus pallidus to putamen gray ratio.The globus pallidus to putamen gray ratio partially mediated the effect of NPY level on ABE complication in children with HNB,with a mediation effect coefficient of 0.183(95%CI:0.147–0.204).Conclusion NPY and the globus pallidus to putamen gray ratio were risk factors for the complication of ABE in children with HNB,and the globus pallidus to putamen gray ratio partially mediated the effect of NPY on ABE.

关 键 词：苍白球 壳核 神经肽Y 高胆红素血症 急性胆红素脑病 

分 类 号：R722.1[医药卫生—儿科]