血清lncRNA H19、Activin A在新生儿缺氧缺血性脑病病情和预后判断中的价值  

The value of serum lncRNA H19 and Activin A in the diagnosis and prognosis of neonatal hypoxic-ischemic encephalopathy

作　　者：赵英娟 李丹青 鲁旭 淡云 许旭 Zhao Yingjuan;Li Danqing;Lu Xu;Dan Yun;Xu Xu(Department of Neonatology,Xianyang Central Hospital,Shaanxi Province,Xianyang 712000,China)

机构地区：[1]陕西省咸阳市中心医院新生儿科,712000

出　　处：《疑难病杂志》2024年第12期1495-1500,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省卫健委卫生健康科研项目(2021D0028)。

摘　　要：目的探讨血清长链非编码RNA H19(lncRNA H19)、激活素A(Activin A)在新生儿缺氧缺血性脑病(HIE)病情和预后判断中的价值。方法选取2019年1月—2023年1月咸阳市中心医院新生儿科收治的HIE患儿207例为HIE组,根据病情程度分为轻度HIE亚组99例、中度HIE亚组61例、重度HIE亚组47例,根据出院时预后情况分为不良预后亚组62例和良好预后亚组145例,另选取同期健康新生儿105例为健康对照组。采用实时荧光定量PCR检测血清lncRNA H19表达水平,酶联免疫吸附法检测血清Activin A水平。多因素非条件Logistic回归模型确定HIE患儿预后影响因素;绘制受试者工作特征(ROC)曲线评价血清lncRNA H19、Activin A水平判断HIE患儿不良预后的价值。结果与健康对照组比较,HIE组血清lncRNA H19表达水平降低,Activin A水平升高(t/P=34.498/<0.001、47.114/<0.001)。轻度、中度、重度HIE亚组血清lncRNA H19表达水平依次降低,Activin A水平依次升高(F/P=267.954/<0.001、349.146/<0.001)。Logistic回归分析结果表明,重度HIE和Activin A升高为HIE患儿不良预后的独立危险因素[OR(95%CI)=6.518(1.824~23.292)、1.537(1.301~1.814)],新生儿行为神经学评估评分增加和lncRNA H19升高为独立保护因素[OR(95%CI)=0.812(0.734~0.898)、0.502(0.387~0.651)];ROC曲线分析结果表明,血清lncRNA H19联合Activin A水平判断HIE患儿不良预后的曲线下面积为0.904,大于血清lncRNA H19、Activin A水平单独判断的0.783、0.790(Z/P=4.030/<0.001、4.048/<0.001)。结论血清lncRNA H19和Activin A水平与HIE患儿病情及预后有关,两者联合检测判断HIE患儿预后的价值较高。Objective To investigate the value of serum long non-coding RNA H19(lncRNA H19)and activin A in the diagnosis and prognosis of neonatal hypoxic-ischemic encephalopathy(HIE).Methods From January 2019 to January 2023,207 children with HIE admitted to the Neonatal Department of Xianyang Central Hospital were selected as the HIE subgroup.According to the severity of the disease,they were divided into 99 cases of mild HIE subgroup,61 cases of moderate HIE subgroup and 47 cases of severe HIE subgroup.According to the prognosis at discharge,they were divided into 62 cases of poor prognosis subgroup and 145 cases of good prognosis subgroup.In addition,105 healthy newborns in the same period were selected as the healthy control group.Serum lncRNA H19 level was detected by real-time fluorescence quantitative PCR,and serum Activin A level was detected by enzyme-linked immunosorbent assay.Taking the prognosis of HIE children as the dependent variable,a multivariate unconditional Logistic regression model was established to determine the influencing factors.ROC curve was drawn to evaluate the value of serum lncRNA H19 and Activin A levels in judging the poor prognosis of HIE children.Results Compared with the healthy control group,the serum level of lncRNA H19 in the HIE subgroup was decreased,and the level of Activin A was increased(t/P=34.498/<0.001,47.114/<0.001).The levels of serum lncRNA H19 in mild,moderate and severe HIE subgroups decreased in turn,and the levels of Activin A increased in turn(F/P=267.954/<0.001,349.146/<0.001).Among the 207 children with HIE,62 cases(29.95%)had poor prognosis.The independent risk factors of poor prognosis in children with HIE were severe HIE and elevated Activin A,the independent protective factors were increased neonatal behavioral neurological assessment score and increased lncRNA H19[OR(95%CI)=6.518(1.824-23.292),1.537(1.301-1.814),0.812(0.734-0.898),0.502(0.387-0.651)];The area under the curve of serum lncRNA H19 combined with Activin A level in judging the poor prognosis of HIE c

关 键 词：新生儿缺氧缺血性脑病 长链非编码RNA H19 激活素A 病情 预后 

分 类 号：R722.1[医药卫生—儿科]