摘要
目的检测新生大鼠缺氧缺血性脑病(HIE)模型血清神经特异性烯醇化酶(NSE)和视椎蛋白样蛋白1(VILIP-1)水平,为HIE早期诊断提供血清学参考指标。方法建立新生大鼠HIE模型,分为假手术组、对照组和治疗组;对照组建模后不予干预,治疗组建模后予维生素E灌胃,每组各48只新生大鼠。以ELISA法检测各组1、6、12、24、48和72h时点血清NSE和VILIP-1水平。以24h时点NSE和VILIP-1水平绘制ROC曲线。结果①对照组12、24、48h时点NSE水平显著高于假手术组,治疗组24、48和72h时点NSE水平显著低于对照组。②对照组12、24、48和72h时点VILIP-1水平均显著高于假手术组,治疗组6、12和24h时点VILIP-1水平显著低于对照组。③NSEROC曲线下面积为0.649(95%CI:0.511～0.898),以1630mg·L-1为阈值,诊断HIE的敏感度为72.4%,特异度为63.7%;VILIP-1ROC曲线下面积为0.840(95%CI:0.622～0.931),以590mg·L-1为阈值,诊断HIE的敏感度为75.9%,特异度为99.9%;NSE与VILIP-1指标结合ROC曲线下面积为0.862(95%CI:0.641～0.944),阳性预测值为0.9013。④维生素E对新生大鼠HIE模型NSE和VILIP-1水平呈下降趋势,但其神经行为学未见改善。结论 HIE可引起新生大鼠NSE和VILIP-1表达升高。VILIP-1诊断HIE的敏感度和特异度高于NSE,两者结合诊断价值更高。
Objective To detect serum NSE and VILIP-1 levels in rats to provide the serum markers for early diagnosis of hypoxic-ischemic encephalopathy（HIE）. Methods Rat HIE model was made and classified in three groups： Sham-operation, control and treatment group, with 48 rats in each group. Serum NSE and VILIP-1 levels were tested at 6 time points（ 1,6,12,24, 48, and 72 h） by killing 4 rats for all groups （sham/sevo/drug groups） with ELISA. Levels of NSE and VILIP-1 at different time points were compared among groups by univariate ANOVA. Diagnostic value of serum NSE and VILIP-1 at 24 h to HIE （ gold standard） were tested by ROC method. Results ~NSE levels elevated in sevo groups, the statistical differences were found at 12,24,48 h time points, and dropped in drug groups, statistical differences were found at 12,24,48,72 h time points. @VILIP-1 increased in sevo groups, statistical differences were found in 12,24,48,72 h groups, and decreased in drug groups, statistical differences were found in 6,12,24 h groups. @For NSE, the area under ROC curve was 0. 649 （95 % C1：0. 511 - 0. 898） and the sensitivity and specificity were 72.4% and 63.7% respectively when the diagnostic criteria was 1 630 mg~ L i. For VILIP-I, the area undery ROC curve was 0. 840 （95% CI：O. 622 - 0. 931 ） and the sensitivity and specificity were 75.9% and 99.9% respectively when the diagnostic cretiria was 590 mg L-l. With the combination of NSE and VILIP-1, the diagnosis of HIE would be more accurate, since the area under ROC curve was 0. 862 （95% CI：0. 641 - 0. 944） and the positive prognosis value was 0. 901 3. @Vitamin E could decrease the serum NSE, VILIP-1 levels in rat with HIE, howerver no improvement of neurobehavior was observed. The expression of both NSE and VILIP-1 was reduced in drug groups than in sevo groups. Conclusions NSE and VILIP-1 increased in HIE. To diagnose HIE, both sensitivity and specificity were higher with VILIP-1 than NSE, and it would be more accurate to combine NSE with VILIP-1.
出处
《中国循证儿科杂志》
CSCD
2013年第4期304-307,共4页
Chinese Journal of Evidence Based Pediatrics
