缺氧缺血性脑病新生儿血清CXCL12、MASP-3水平与病情、预后的相关性研究  

Correlation of serum CXCL12 and MASP-3 levels with the condition and prognosis of neonates with hypoxic-ischemic encephalopathy

作　　者：刘惠 袁琪 陈娟[1] 曾春野[1] 许玉峰[1] LIU Hui;YUAN Qi;CHEN Juan;ZENG Chunye;XU Yufeng(Department of Paediatrics,Huaibei People's Hospital,Huaibei,Anhui 235000,China)

机构地区：[1]淮北市人民医院儿科,安徽淮北235000

出　　处：《安徽医药》2025年第4期788-792,共5页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省淮北市科技计划立项项目(2020HK08)。

摘　　要：目的探讨缺氧缺血性脑病(HIE)新生儿血清趋化因子12(CXCL12)、甘露糖结合凝集素相关丝氨酸蛋白酶3(MASP-3)表达情况及与病情、预后的关系,为新生儿HIE预后评估提供有效依据。方法选取2021年2月至2023年2月于淮北市人民医院收治的HIE病人142例为观察组(n=142),另选取同期于该院分娩的足月健康新生儿为对照组(n=142),根据HIE疾病严重程度将病儿分为重度组(n=36)、中度组(n=55)和轻度组(n=51)。根据HIE预后评价标准将病儿分为预后不良组(n=41)和预后良好组(n=101)。比较各组血清CXCL12、MASP-3水平;logistic回归分析HIE预后不良的影响因素;ROC曲线分析血清CXCL12、MASP-3对HIE预后的判断价值。结果观察组血清CXCL12水平(25.30±6.31)μg/L均显著高于对照组(12.62±2.81)μg/L(P<0.05),MASP-3水平(316.17±76.82)μg/L显著低于对照组(513.63±116.62)μg/L(P<0.05);血清CXCL12水平随着疾病严重程度增加而上升(P<0.05),血清MASP-3水平随着疾病严重程度增加而下降(P<0.05);预后不良组阿普加(Apgar)评分、血清MASP-3水平均显著低于预后良好组(均P<0.05),预后不良组开始治疗日龄、母体贫血发生比例、血清CXCL12水平均显著高于预后良好组(均P<0.05);开始治疗日龄、CXCL12是HIE预后不良的独立危险因素(均P<0.05),MASP-3是保护因素(P<0.05);血清CXCL12、MASP-3以及两者联合诊断HIE预后不良的AUC分别为0.82、0.74、0.89,联合诊断的灵敏度为87.37%,特异度为75.25%,二者联合优于血清CXCL12、MASP-3各自单独诊断(Z_(二者联合-CXCL12)=2.83、Z_(二者联合-MASP-3)=2.62,均P<0.05)。结论HIE新生儿血清CXCL12水平升高、MASP-3水平降低,且与HIE疾病严重程度及预后密切相关,两者联合对判断病儿的预后具有较高的价值。Objective To explore the relationship between serum CXC chemokine ligand-12(CXCL12),mannose-binding lectin-associated serine protease-3(MASP-3)and the condition and prognosis of neonates with hypoxic-ischemic encephalopathy(HIE),so as to provide an effective basis for the prognosis evaluation of neonatal HIE.Methods A total of of 142 HIE patients,admitted to Huaibei People's Hospital from February 2021 to February 2023,were collected as the observation group(n=142),and full-term healthy neonates delivered in the same hospital during the same period were selected as the control group(n=142).According to the severity of HIE,the children were grouped into severe group(n=36),moderate group(n=55),and mild group(n=51).According to the evaluation criteria for poor prognosis of HIE,the children were grouped into a poor prognosis group(n=41)and a good prognosis group(n=101).The levels of serum CXCL12 and MASP-3 were compared among groups;Logistic regression was applied to analyze the influencing factors for poor prognosis of HIE;receiver operating characteristic(ROC)curve was applied to analyze the value of serum CXCL12 and MASP-3 in prognosis evaluation of HIE.Results Compared with the control group,the observation group had a higher level of serum CXCL12[(25.30±6.31)μg/L vs.(12.62±2.81)μg/L](P<0.05),and a lower level of MASP-3[(316.17±76.82)μg/L vs.(513.63±116.62)μg/L](P<0.05);the serum CXCL12 level increased with the worsening of the disease(P<0.05),while the serum MASP-3 level decreased with the worsening of the disease(P<0.05).The Apgar score and serum MASP-3 level in the poor prognosis group were obviously lower than those in the good prognosis group(P<0.05),and the age at the start of treatment,the proportion of maternal anemia,and serum CXCL12 level in the poor prognosis group were obviously higher than those in the good prognosis group(P<0.05);age at the start of treatment and CXCL12 were independent risk factors for poor prognosis of HIE(P<0.05),while MASP-3 was a protective factor(P<0.05).The areas unde

关 键 词：缺氧缺血 脑 婴儿 新生 趋化因子12 甘露糖结合凝集素相关丝氨酸蛋白酶3 病情程度 预后 

分 类 号：R722.1[医药卫生—儿科]