摘要
[目的]探讨动态监测缺氧缺血性脑病(HIE)患儿血清TGF‐β1变化的临床意义.[方法]选择2017年1月至2018年12月30日本院新生儿科收治的40例HIE患儿为研究对象,根据HIE临床分度标准,将其分为轻度组(19例)、中度组(11例)、重度组(10例).选择同期住院分娩的20例健康新生儿纳入对照组.检测两组研究对象外周血转化生长因子‐β1 (TGF‐β1)水平并进行新生儿神经行为测定(NBNA)检查.使用ROC曲线分析TGF‐β1对中重度HIE的诊断价值.[结果]四组新生儿在性别、胎龄、生产方式、母亲为初产妇、母亲流产史、宫内感染、胎膜早破方面差异无统计学意义( P >0 .05);而出生后24h、72hTGF‐β1水平差异存在统计学意义(P <0.05),出生后1周,各组TGF‐β1水平差异无统计学意义( P >0 .05).随着病情加重,患儿TGF‐β1水平和NBNA评分逐渐降低,其差异有统计学意义( P <0 .05).出生后24 h 、72 h 、1周,TGF‐β1水平与NBNA 评分呈正相关( r =0 .523 、0.513 、0.428).出生后24 h ,TGF‐β1诊断中重度 HIE最佳临界点为15.6 μg/L ,灵敏度为71.5%,特异度为79 .5%;AUC曲线下面积为0.78 .[结论]随着HIE病情加重,TGF‐β1水平降低,且与NBNA评分呈正相关.
[Objective]To investigate the clinical significance of dynamic monitoring of serum TGF‐β1 in chil‐dren with hypoxic ischemic encephalopathy (HIE ).[M ethods]A total of 40 children with HIE admitted to the neonatology department of our hospital from January 2017 to December 30 ,2018 were enrolled .According to the HIE clinical classification criteria ,they were divided into mild group (19 cases) ,moderate group (19 cases) and severe group (10 cases).Twenty healthy new borns of hospital delivery during the same period were included in the control group .Levels of peripheral blood transforming grow th factor‐β1 (TGF‐β1 ) were measured and neonatal neurobehavioral assay (NBNA ) were examined in all groups .T he diagnostic value of TGF‐β1 for moderate to se‐vere HIE was analyzed using ROC curves .[Results]T here were no significant differences in gender ,gestational age ,mode of delivery ,maternal primipara ,abortion history ,intrauterine infection and premature rupture of mem‐branes in the four groups ( P >0 .05).T here were significant differences in TGF‐β1 levels between 24 h and 72 h after birth ( P <0 .05).However ,one week after birth ,there was no significant difference in TGF‐β1 levels in all groups ( P >0 .05).T he decrease of TGF‐β1 level and NBNA score of the HIE children reflected the severity of HIE;the difference was statistically significant ( P <0 .05).At 24 h ,72 h ,and 1 week after birth ,TGF‐β1 levels were positively correlated with NBNA scores ( r =0 .523 ,0 .513 ,0 .428).A t 24 h after birth ,the optimal critical point for TGF‐β1 diagnosis of moderate‐severe HIE was 15 .6 μg/L ,the sensitivity was 71 .5%,the specificity was 79.5%,and the area under the AUC curve was 0 .78 .[Conclusion]In the order of mild‐moderate‐severe HIE , TGF‐β1 levels decrease and are positively correlated with NBNA scores .
作者
黄健
邬吉伟
罗睿彬
丘惠娴
HUANG Jian;WU Ji-wei;LUO Rui-bin(Department of Neonatology , Longgang Central Hospital, Shenzhen 518116, China)
出处
《医学临床研究》
CAS
2019年第9期1733-1735,共3页
Journal of Clinical Research
