窒息性脑损伤新生儿血清NFL和sNRG-1检测及意义  

Determination and significance of serum neurofilament light protein and soluble neuregulin-1 in neonates with asphyxial brain injury

作　　者：杜锟 李欣 赵楠 DU Kun;LI Xin;ZHAO Nan(Department of Neonatology,Shangqiu First People′s Hospital,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院新生儿科,河南商丘476100 [2]商丘市第一人民医院NICU,河南商丘476100

出　　处：《青岛大学学报(医学版)》2025年第1期115-119,共5页Journal of Qingdao University(Medical Sciences)

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191492)。

摘　　要：目的探讨窒息性脑损伤新生儿血清神经丝蛋白(NFL)和可溶性神经调节蛋白-1(sNRG-1)表达及其预测价值。方法选取2021年2月—2023年2月商丘市第一人民医院收治的212例足月新生儿作为研究对象,其中以112例足月窒息新生儿作为研究组、100例足月健康新生儿作为对照组。研究组根据窒息程度分为轻度窒息组(63例)和重度窒息组(49例),根据是否脑损伤分为脑损伤组(40例)和无脑损伤组(72例)。分析血清NFL和sNRG-1检测对窒息性脑损伤的评估价值,以及影响该病发生的风险因素。结果与对照组比较,轻度窒息组和重度窒息组病儿血清NFL均明显升高,而sNRG-1均明显降低(F=17.787、13.044,P<0.05);且随着新生儿窒息程度加重,血清NFL逐渐升高而血清sNRG-1逐渐降低(P<0.05)。与无脑损伤组病儿比较,脑损伤组血清NFL明显升高而sNRG-1明显降低(t=21.250、37.737,P<0.05)。血清NFL和sNRG-1检测对新生儿窒息性脑损伤评估的受试者工作特征曲线下面积(AUC)分别为0.736和0.829,两者联合评估的AUC为0.902,其特异度为85.4%,灵敏度为87.5%。多因素Logistic回归分析显示,脐带异常、NFL≥61.7 ng/L和sNRG-1<1.1 ng/L等是影响新生儿窒息性脑损伤发生的危险因素(P<0.05)。结论血清NFL升高和sNRG-1降低均是影响新生儿窒息加重及发生脑损伤的风险因素,两者可作为评估新生儿窒息病情及并发脑损伤的生物学标记物。Objective To investigate the expression and predictive value of serum neurofilament light protein(NFL)and soluble neuregulin-1(sNRG-1)in neonates with asphyxial brain injury.Methods A total of 212 full-term neonates who were admitted to Department of Neonatology,The First People′s Hospital of Shangqiu City,from February 2021 to February 2023 were enrolled as subject,among whom there were 112 asphyxiated full-term neonates(study group)and 100 healthy full-term neonates(control group).According to the degree of asphyxia,the neonates in the study group were divided into mild asphyxia group with 63 neonates and severe asphyxia group with 49 neonates,and according to the presence or absence of brain injury,they were divi-ded into brain injury group with 40 neonates and non-brain injury group with 72 neonates.The value of serum NFL and sNRG-1 in assessing asphyxial brain injury was analyzed,as well as the risk factors for this disease.Results Compared with the control group,the mild asphyxia group and the severe asphyxia group had a significant increase in the serum level of NFL and a significant reduction in the serum level of sNRG-1(F=17.787,13.044,P<0.05);with the aggravation of neonatal asphyxia,the serum level of NFL gradually increased,and the serum level of sNRG-1 gradually decreased(P<0.05).Compared with the non-brain injury group,the brain injury group had a significant increase in the serum level of NFL and a significant reduction in the serum level of sNRG-1(t=21.250,37.737,P<0.05).Serum NFL and sNRG-1 had an area under the ROC curve(AUC)of 0.736 and 0.829,respectively,for evaluating asphyxial brain injury in neonates,and the combination of serum NFL and sNRG-1 had an AUC of 0.902,with a specificity of 85.4%and a sensitivity of 87.5%.The multivariate Logistic regression analysis showed that abnormal umbilical cord,NFL≥61.7 ng/L,and sNRG-1<1.1 ng/L were risk factors for asphyxial brain injury in neonates(P<0.05).Conclusion Both the increase in serum NFL and the reduction in sNRG-1 are risk factors for the

关 键 词：新生儿窒息 低氧 脑 神经微丝蛋白质类 神经调节蛋白1 影响因素分析 

分 类 号：R722.12[医药卫生—儿科] R349.12[医药卫生—临床医学]