血清IL-23 UCH-L1 miR-424与足月新生儿HIE病情程度的关系及预测预后价值  

The Relationship of Serum Levels of Il-23 Uch-L1 and Mir-424 with Severity of Hypoxic-Ischemic Encephalopathy(Hie)in Full-Term Newborns and the Predictive Value on Prognosis

作　　者：张娟[1] 李翔 余珊 肖洪 肖赛武 杨春佳 ZHANG Juan(Hunan Maternal and Child Health Hospital,Hunan Changsha 410000,China)

机构地区：[1]湖南省妇幼保健院新生儿科,湖南长沙410000 [2]湖南省长沙市妇幼保健院,湖南长沙410000 [3]湖南省龙山县人民医院,湖南龙山416899 [4]湖南省武冈市人民医院新生儿科,湖南武冈422499 [5]湖南省邵阳市妇幼保健院儿科,湖南邵阳422001

出　　处：《河北医学》2024年第12期2017-2023,共7页Hebei Medicine

基　　金：湖南省创新型省份建设项目,(编号:S2020JJZZLH01903)。

摘　　要：目的:探讨血清白介素-23(IL-23)、泛素羧基末端水解酶-L1(UCH-L1)、微小RNA-424(miR-424)与足月新生儿缺氧缺血性脑病(HIE)病情程度的关系及预测预后价值。方法:选取2019年1月至2022年12月足月HIE患儿105例作为HIE组,根据HIE分度标准分为轻度患儿(37例)、中度患儿(43例)及重度患儿(25例),另选取同期足月健康新生儿105例作为对照组。于所有受试者入组1d内采集空腹静脉血,采用酶联免疫吸附法检测血清IL-23、UCH-L1水平,实时荧光定量聚合酶联反应(qRT-PCR)法检测miR-424水平,比较HIE组和对照组血清IL-23、UCH-L1、miR-424水平,分析血清IL-23、UCH-L1、miR-424与HIE病情程度的关系。对HIE组随访1年,根据预后情况分为预后良好组与预后不良组,比较两组血清IL-23、UCH-L1、miR-424,分析血清IL-23、UCH-L1、miR-424对预后的预测价值。结果:HIE组血清IL-23(68.67±21.29)ng/L、UCH-L1(1.98±0.63)ng/mL高于对照组(30.06±6.13)ng/L、(0.75±0.24)ng/mL,miR-424(1.98±0.63)低于对照组(1.02±0.11)(P<0.05);重度患儿血清IL-23(95.21±21.08)ng/L、UCH-L1(2.42±0.46)ng/mL高于中度患儿(70.49±18.13)ng/L、(2.01±0.40)ng/mL、轻度患儿(48.62±14.72)ng/L、(1.65±0.34)ng/mL,中度患儿高于轻度患儿,miR-424(0.53±0.10)低于中度患儿(0.70±0.12)、轻度患儿(0.84±0.16),中度患儿低于轻度患儿(P<0.05);血清IL-23、UCH-L1与病情程度呈正相关,miR-424与病情程度呈负相关(P<0.05);随访1年,失访1例。104例患儿中预后良好82例,预后不良22例。预后不良组出生1min Apgar评分、5min Apgar评分、NBNA评分低于预后良好组,病情程度高于预后良好组(P<0.05);预后不良组血清IL-23(94.41±20.35)ng/L、UCH-L1(2.46±0.62)ng/mL高于预后良好组(61.76±18.74)ng/L、(1.84±0.49)ng/mL,miR-424(0.51±0.16)低于预后良好组(0.75±0.20)(P<0.05);偏相关性分析,控制其他因素后,血清IL-23、UCH-L1、miR-424与足月HIE患儿预后情况显著相关(P<0.05);血清IL-23、UCH-L1、miR-Objective:To investigate the relationship of serum interleukin-23(IL-23),ubiquitin carboxy-terminal hydrolase L1(UCH-L1)and micrnas 424(miR-424)with the severity of hypoxic-ischemic encephalopathy(HIE)in full-term neonates and their predictive value on prognosis.Methods:A total of 105 cases of full-term infants with HIE diagnosed in the period from January 2019 to December 2022 were selected as the HIE group,which were further divided into mild(37 cases),moderate(43 cases),and severe(25 cases)subgroups according to the HIE grading criteria.Additionally,105 cases of full-term healthy newborns from the same period were selected as the control group.Venous blood samples were collected from all subjects within one day of enrollment,and serum levels of IL-23 and UCH-L1 were measured using enzyme-linked immunosorbent assay(ELISA),while serum miR-424 levels were determined using real-time quantitative polymerase chain reaction(qRT-PCR).The serum levels of IL-23,UCH-L1,and miR-424 were compared between the HIE group and the control group,and the correlation between these markers and the severity of HIE was analyzed.The HIE group was followed up for one year,and according to the prognosis,they were further divided into the good prognosis subgroup and the poor prognosis subgroup.The serum levels of IL-23,UCH-L1,and miR-424 were compared between these two subgroups,and the predictive value of these markers for prognosis was analyzed.Results:The serum levels of IL-23(68.67±21.29)ng/L and UCH-L1(1.98±0.63)ng/mL in the HIE group were higher than those in the control group(30.06±6.13)ng/L and(0.75±0.24)ng/mL,respectively.Meanwhile,the serum level of miR-424(1.98±0.63)was lower than that in the control group(1.02±0.11)(P<0.05).In the severe HIE subgroup,the serum levels of IL-23(95.21±21.08)ng/L and UCH-L1(2.42±0.46)ng/mL were higher than those in the moderate HIE subgroup(70.49±18.13)ng/L and(2.01±0.40)ng/mL,respectively,and those in the mild HIE subgroup(48.62±14.72)ng/L and(1.65±0.34)ng/mL.The moderate HIE subgrou

关 键 词：足月新生儿 缺氧缺血性脑病 白介素-23 泛素羧基末端水解酶-L1 微小RNA-424 

分 类 号：R722.1[医药卫生—儿科]