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| 血清血红素氧化酶-1预测早产儿脑损伤及近期预后的临床价值 | |
| 引用本文： | 刘慧苹,蒋峰原,宋忠瑞,徐尚,王鹏伟,杨阳阳,黄智勇,吴书晗,郭玉秀,舒桂华. 血清血红素氧化酶-1预测早产儿脑损伤及近期预后的临床价值[J]. 中华临床医师杂志(电子版), 2020, 14(11): 899-905. DOI: 10.3877/cma.j.issn.1674-0785.2020.11.010 |
| 作者姓名： | 刘慧苹 蒋峰原 宋忠瑞 徐尚 王鹏伟 杨阳阳 黄智勇 吴书晗 郭玉秀 舒桂华 |
| 作者单位： | 1. 225001 江苏扬州，扬州大学临床医学院新生儿科2. 现在湖北省第三人民医院新生儿科)；211900 江苏仪征，南京鼓楼医院集团仪征医院儿科3. 225001 江苏扬州，江苏省苏北人民医院新生儿科 |
| 基金项目： | 江苏省妇幼健康科研项目(F201646) |
| 摘 要： | 摘要 探讨血清血红素氧化酶-1（HO-1）水平预测早产儿脑损伤及近期预后的临床价值。 方法选取2017年9月至2019年9月于扬州大学临床医学院新生儿重症监护病房住院的120例早产儿为研究对象，根据头颅B超及MRI结果分为脑室周围-脑室内出血（PIVH）组（35例）、脑室周围白质软化（PVL）组（15例）、无脑损伤组（70例）。监测并比较血清HO-1、血清白介素-6（IL-6）水平及振幅整合脑电图（aEEG）、行为神经测定（NBNA）评分；绘制血清HO-1、IL-6水平及aEEG、NBNA评分的受试者工作特征曲线（ROC）图，计算出敏感度、特异度，并根据ROC曲线下面积（AUC）大小，比较血清HO-1、IL-6水平及aEEG、NBNA评分对早产儿脑损伤及近期预后的预测价值。 结果（1）PIVH组、PVL组不同时间点血清HO-1、IL-6水平高于无脑损伤组，而1周内aEEG评分均低于无脑损伤组，差异均有显著统计学意义（P＜0.01）。（2）纠正胎龄40周时PIVH组、PVL组aEEG、NBNA评分均明显低于无脑损伤组，差异均具有显著统计学意义（P＜0.01）。（3）血清HO-1与血清IL-6呈正相关（r=0.814，P＜0.01），与1周内aEEG评分呈负相关（r=-0.671，P＜0.01）。血清HO-1水平与纠正胎龄40周时aEEG、NBNA评分呈负相关（r=-0.631、-0.666，均P＜0.01）。（4）血清HO-1、IL-6水平及1周内aEEG评分的ROC曲线下面积为0.812、0.917、0.901，敏感度分别为85.3%、93.0%、88.2%，特异度为84.0%、86.1%、96.7%。纠正胎龄40周时aEEG、NBNA评分的ROC曲线下面积为0.809、0.851，敏感度为87.3%、84.5%，特异度89.1%、96.2%。 结论血清HO-1可作为预测早产儿脑损伤及近期预后的敏感、特异指标，有一定的临床应用价值。 |
| 关 键 词： | 血红素氧化酶-1 振幅整合脑电图 早产儿 脑损伤 预测 |
| 收稿时间： | 2020-03-24 |
Clinical value of serum heme oxygenase-1 in predicting brain injury and short-term prognosis in premature infants |
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| Huiping Liu,Fengyuan Jiang,Zhongrui Song,Shang Xu,Pengwei Wang,Yangyang Yang,Zhiyong Huang,Shuhan Wu,Yuxiu Guo,Guihua Shu. Clinical value of serum heme oxygenase-1 in predicting brain injury and short-term prognosis in premature infants[J]. Chinese Journal of Clinicians(Electronic Version), 2020, 14(11): 899-905. DOI: 10.3877/cma.j.issn.1674-0785.2020.11.010 | |
| Authors: | Huiping Liu Fengyuan Jiang Zhongrui Song Shang Xu Pengwei Wang Yangyang Yang Zhiyong Huang Shuhan Wu Yuxiu Guo Guihua Shu |
| Affiliation: | 1. Department of Neonatology, Clinical Medical College, Yangzhou University, Yangzhou 225001, China 2. Department of Pediatrics, Yizheng Hospital, Drum Tower Hospital Group of Nanjing, Yizheng 211900, China 3. Department of Neonatology, Northern Jiangsu People's Hospital, Yangzhou 225001, China |
| Abstract: | ObjectiveTo evaluate the clinical value of serum heme oxygenase-1 (HO-1) in predicting brain injury and short-term prognosis of premature infants. MethodsFrom September 2017 to September 2019, a total of 120 premature infants hospitalized in neonatal intensive care unit of Clinical Medical College of Yangzhou University were included as subjects. According to head ultrasound and MRI results, 120 neonates were divided into a periventriclar-intraventricular hemorrhage (PIVH) group (n=35), a periventricular leukomalacia (PVL) group (n=15), and a no brain injury group (n=70). Serum HO-1 and interleukin-6 (IL-6) levels, amplitude-integrated electroencephalogram (aEEG) score, and neonatal behavioral neurological assessment (NBNA) score were recorded and compared. The receiver operating characteristic curves (ROC) of serum HO-1 and IL-6 levels, aEEG score, and NBNA score were plotted to calculate their sensitivity and specificity in the prediction of brain injury and short-term prognosis in premature infants based on the area under the ROC curve (AUC). ResultsSerum HO-1 and IL-6 levels in the PIVH group and PVL group at different time points were significantly higher than those of the non-brain injury group, while aEEG score within one week was significantly lower than that of the non-brain injury group (P＜0.01). aEEG and NBNA scores in the PIVH and PVL group were significantly lower than those of the non-brain injury group at 40 weeks of gestation age (P＜0.01). Serum HO-1 was positively correlated with serum IL-6 (r = 0.814, P＜0.01), while it was negatively correlated with aEEG score within one week (r=-0.671, P＜0.01). Serum HO-1 was negatively correlated with aEEG score and NBNA score at 40 weeks of gestation (r=-0.631 and -0.666, respectively, P＜0.01). The areas under the ROC curves of serum HO-1 and IL-6 levels and aEEG score within a week were 0.812, 0.917, and 0.901, respectively; the corresponding sensitivities were 85.3%, 93.0% and 88.2%, and the corresponding specificities were 84.0%, 86.1%, and 96.7%, respectively. The area under the ROC curve of aEEG and NBNA scores at 40 weeks of gestation were 0.809 and 0.851, respectively; the sensitivities were 87.3% and 84.5%, and the specificities were 89.1% and 96.2%, respectively. ConclusionSerum HO-1 can be used as a sensitive and specific index to predict brain injury and short-term prognosis of premature infants, which has appreciated clinical application value. |
| Keywords: | Serum heme oxygenase-1 Amplitude-integrated electroencephalogram Preterm infants Brain injury Predictive |
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