脂联素与超敏C-反应蛋白联合检测在新生儿缺氧缺血性脑病中的意义

The Significance of Adiponectin with Ultra-Sensitive C-Reactive Protein Joint Detection in Neonates with Hypoxic-Ischemic Encephalopathy

目的探讨脂联素(APN)与超敏C-反应蛋白(hs-CRP)联合在检测新生儿缺氧缺血性脑病(HIE)中的意义。方法选择我院自2011年5月至2012年6月的78例缺氧缺血性脑病的新生儿(轻度21例、中度40例,重度17例),选择同一时期的正常新生儿40例作为对照组,对两组新生儿的APN和hs-CRP水平进行动态测定,对比分析两组患者两项指标的差异性。结果与正常对照组比较,HIE新生儿的APN明显降低,差异具有统计学意义(P<0.01);治疗后的第7、14、30d与开始治疗时比较,APN水平具有升高趋势(P<0.05),hs-CRP水平具有下降趋势(P<0.05);治疗30d比较,轻度新生儿组、中度新生儿组与正常对照组比较,APN值无统计学差异(P>0.05),对照组与重度组APN值差异显著(P<0.05);中度组和重度组hs-CRP值与正常对照组比较无统计学差异性(P>0.05)。结论 HIE新生儿的APN水平与神经系统的损失及炎症状态具有一定的负相关性,hs-CRP是新生儿缺氧缺血性脑病的独立危险因子,与发病危险呈正相关性,联合检测APN和hs-CRP水平,对HIE患者的病情诊断及预后具有重要的临床意义。

Objective To investigate the significance of adiponectin （APN） and high-sensitivity C-reactive protein （hs-CRP） joint detection in neonatal hypoxic-ischemic encephalopathy （HIE）. Methods 78 cases of neonatal hypoxic-ischemic encephalopathy （21 cases with mild, moderate 40 cases, 17 cases of severe） in our hospital from May 2011 to June 2012 were chosen. 40 normal newborns the same period were chosen as the control group. The neonatal APN and hs-CRP levels dynamic of the two groups was taken for detection. The differences of the two indicators for the two groups were taken for comparative analysis. Results Compared with the normal control group, the APN of the HIE newboms was significantly lower, the difference was statistically significant （P 〈0.01）. 7 days, 14 days and 30 days after treatment compared with before treatment, the APN level had tended to increase （P 〈0.05）, hs-CRP level was with a downward trend （P〈0.05）. After treatment for 30 days, the mild neonatal group, moderate neonatal group and normal control group were taken for comparison, the APN value was with no significant difference （P 〉0.05）. The differences of APN value in the control group and severe group were significantly different （P 〈0.05）. The hs-CRP values in the moderate group and severe group compared with the normal control group, there were no significant differences （P 〉0.05）. Conclusions The APN level of the HIE newborns has certain negative correlation with the loss and inflammation of the nervous system state, hs-CRP is an independent risk factor for neonatal hypoxic-ischemic encephalopathy, it is positively correlated with cancer risk. The combination detection of APN and hs-CRP levels has important clinical significance for the diagnosis and prognosis of the patients with hypoxic-ischemic encephalopathy.