血清肌酸激酶脑型同工酶胰岛素样生长因子-1中性粒细胞-巨噬细胞集落刺激因子水平对新生儿缺氧缺血性脑病预后的预测价值  

Prognostic value of serum CK-BB,GM-CSF,and IGF-1 levels in predicting the prognosis of neonatal hypoxic-ischemic encephalopathy

作　　者：杜亚丽 史珑 Du Yali;Shi Long(Department of Pediatrics,General Hospital of Pingmei Medical Group,Henan 467000,China)

机构地区：[1]平煤神马医疗集团总医院儿科,平顶山467000

出　　处：《山西医药杂志》2025年第7期493-496,共4页Shanxi Medical Journal

摘　　要：目的分析血清肌酸激酶脑型同工酶(CK-BB)、胰岛素样生长因子-1(IGF-1)、中性粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平对新生儿缺氧缺血性脑病(HIE)患儿预后的预测价值。方法选取2021年2月至2023年5月该院收治的75例HIE患儿为研究对象。随访1个月,统计患儿预后情况,比较不同病情程度患儿血清CK-BB、GM-CSF、IGF-1水平,血清CK-BB、GM-CSF、IGF-1水平与病情严重程度相关性,不同预后患儿出生后24 h内血清CK-BB、GM-CSF、IGF-1水平变化,分析出生后24 h内血清CK-BB、GM-CSF、IGF-1水平对1个月内预后不良的预测价值。结果3组血清CK-BB、GM-CSF水平比较,轻度组<中度组<重度组,3组血清IGF-1水平比较,轻度组>中度组>重度组,差异均有统计学意义(P<0.05);血清CK-BB、GM-CSF与病情严重程度(赋值:轻度=1、中度=2、重度=3)呈正相关,而IGF-1与病情严重程度呈负相关,差异有统计学意义(P<0.05);出生后24 h内,预后良好组血清CK-BB、GM-CSF水平均低于预后不良组,血清IGF-1水平高于预后不良组,差异有统计学意义(P<0.05);以预后不良患者为阳性样本,以预后良好患者为阴性样本,绘制受试者工作特征(ROC)曲线,结果显示,CK-BB、GM-CSF、IGF-1水平单独及联合检测预测1个月内预后不良的曲线下面积(AUC)分别为0.786、0.832、0.748、0.916,均具有一定诊断效能,且联合检测诊断效能最高。结论HIE患儿血清CK-BB、GM-CSF水平升高,IGF-1水平降低,且与病情严重程度密切相关,可作为预测患儿预后不良的潜在指标,且联合检测的预测价值高于单一检测。Objective To analyze the correlation between the levels of serum creatine kinase brain-type isoenzyme(CK-BB),insulin-like growth factor(IGF)-1,and granulocyte-macrophage colony stimulating factor(GM-CSF)and the severity of neonatal hypoxic ischemic encephalopathy(HIE),as well as their prognostic value.Methods Seventy-five newborn infants with HIE from February 2021 to May 2023 were selected as the research subjects.The levels of serum CK-BB,GM-CSF,and IGF-1 were compared among infants with different disease severity,and their correlation with disease severity was analyzed.The newborn infants with HIE were given conventional treatment and divided into a good prognosis group and a poor prognosis group based on the prognosis of the infants within one month.The changes in the levels of each serum index were compared,and the predictive value of each serum index for poor prognosis was analyzed.Results With the aggravation of the disease degree,serum CK-BB and GM-CSF levels tended to increase,and IGF-1 levels tended to decrease(P<0.05).Serum CK-BB and GM-CSF were positively correlated with the severity of the disease degree,whereas IGF-1 was inversely correlated with it(P<0.05).Compared with the group with a good prognosis,the group with a poor prognosis had elevated levels of serum CK-BB,GM-CSF,and IGF-1 levels decreased(P<0.05).The area under the curve(AUC)of the combined detection of serum CK-BB,GM-CSF,and IGF-1 for predicting poor prognosis of children within 1 month was higher than that predicted by the indicators alone(P<0.05).Conclusion The levels of serum CK-BB and GM-CSF were higher in neonates with HIE,while the levels of IGF-1 was lower,which was closely related to the severity of the disease.The combined detection of their levels had a certain predictive value for prognosis.

关 键 词：新生儿 缺氧缺血 脑 肌酸激酶 胰岛素样生长因子Ⅰ 中粒细胞-巨噬细胞集落刺激因子 预测 

分 类 号：R722.1[医药卫生—儿科]