彩色多普勒超声联合血清微小RNA-128-3p检测对新生儿缺氧缺血性脑病预后的预测价值  

Predictive value of color Doppler ultrasound combined with serum miR-128-3p detection for prognosis of neonates with HIE

作　　者：吕怡翔 白振华 王小玉 LYU Yixiang;BAI Zhenhua;WANG Xiaoyu(Department of Ultrasound Medicine,Luoyang Maternal and Child Health Hospital,Luoyang 471000,China;Department of Neonatology,Luoyang Maternal and Child Health Hospital,Luoyang 471000,China)

机构地区：[1]洛阳市妇幼保健院超声医学科,河南洛阳471000 [2]洛阳市妇幼保健院新生儿科,河南洛阳471000

出　　处：《陕西医学杂志》2025年第3期328-332,共5页Shaanxi Medical Journal

基　　金：河南省医学科技攻关计划项目(LHGJ20201037)。

摘　　要：目的:探讨彩色多普勒超声参数联合血清微小RNA-128-3p(miR-128-3p)检测对缺氧缺血性脑病(HIE)新生儿预后的预测价值。方法:回顾性选取HIE患儿118例,依据病情程度分为轻度组(69例)和中重度组(49例),比较两组彩色多普勒超声参数[收缩期峰值流速(Vs)、舒张末期速度(Vd)、平均流速(Vm)、搏动指数(PI)、阻力指数(RI)]和血清miR-128-3p水平。比较不同预后患儿一般资料、彩色多普勒超声参数(Vs、Vd、Vm、PI、RI)以及血清miR-128-3p水平。分析HIE患儿预后的影响因素及各指标对患儿预后的预测价值。结果:与轻度组比较,中重度组Vs、Vd、Vm较低,PI、RI和血清miR-128-3p水平较高(均P<0.05)。118例患儿中,预后不良36例,预后良好82例。预后不良组体重、Vs、Vd、Vm低于预后良好组,胎儿酸中毒和中重度病情占比、PI、RI以及血清miR-128-3p水平高于预后良好组(均P<0.05)。体重≤3230.51 g、有胎儿酸中毒、病情程度中重度、Vs≤30.80 cm/s、Vd≤10.39 cm/s、Vm≤18.58 cm/s、PI≥1.22、RI≥0.62、miR-128-3p≥1.97为HIE患儿预后的危险因素(均P<0.05)。彩色多普勒超声参数和血清miR-128-3p均可预测HIE患儿预后,联合检测的预后价值高于单项(均P<0.05)。结论:彩色多普勒超声参数和血清miR-128-3p水平与HIE患儿病情程度、预后关系密切,可作为临床预测HIE患儿预后的有效参考。Objective:To study the predictive value of color Doppler ultrasound parameters combined with serum microRNA-128-3p(miR-128-3p)in the prognosis of neonates with hypoxic-ischemic encephalopathy(HIE).Methods:A total of 118 neonates with HIE were retrospectively selected.According to the severity of HIE,they were divided into mild group(69 cases)and moderate to severe group(49 cases).The color Doppler ultrasound parameters(Vs,Vd,Vm,PI,RI)and serum miR-128-3p levels were compared between the two groups.The general data,color Doppler ultrasound parameters(Vs,Vd,Vm,PI,RI)and serum miR-128-3p levels of children with different prognosis were compared.The influencing factors of the prognosis of neonates with HIE and the predictive value of each index for the prognosis of neonates were analyzed.Results:Compared with the mild group,the Vs,Vd and Vm in the moderate to severe group were lower,and PI,RI and serum miR-128-3p level were higher(all P<0.05).Among 118 children,36 had poor prognosis and 82 had good prognosis.The body weight,Vs,Vd,and Vm in the poor prognosis group were lower than those in the good prognosis group,and the proportion of fetal acidosis and moderate to severe disease,and PI,RI,serum miR-128-3p level were higher than those in the good prognosis group(all P<0.05).Weight≤3230.51 g,fetal acidosis,moderate to severe disease,Vs≤30.80 cm/s,Vd≤10.39 cm/s,Vm≤18.58 cm/s,PI≥1.22,RI≥0.62,and miR-128-3p≥1.97 were risk factors for the prognosis of neonates with HIE(all P<0.05).Color Doppler ultrasound parameters and serum miR-128-3p could predict the prognosis of neonates with HIE,and the prognostic value of combined detection was higher than that of single detection(all P<0.05).Conclusion:Color Doppler ultrasound parameters and serum miR-128-3p level are closely related to the severity and prognosis of neonates with HIE,which can be used as effective references for clinical prediction of the prognosis of neonates with HIE.

关 键 词：缺氧缺血性脑病 彩色多普勒超声 微小RNA-128-3p 新生儿 预后 预测价值 

分 类 号：R722.1[医药卫生—儿科]