胰岛素样生长因子-1、热休克蛋白70与新生儿窒息的相关性研究

Correlation Study between Insulin-like Growth Factor-1,HSP70 and Neonatal Asphyxia

目的探讨胰岛素样生长因子-1(IGF-1)、热休克蛋白70(HSP70)与新生儿窒息的相关性,及其在窒息诊断中的参考价值。方法选择2013年11月至2016年5月在我院产科出生的足月新生儿146例。其中,轻度窒息51例,重度窒息45例,另随机选取Apgar评分正常的新生儿50例为对照组。胎儿娩出立即抽取脐动脉血2m L。采用ELISA分别检测各组血清中IGF-1、HSP70的表达水平。结果 3组血清中IGF-1、HSP70的表达水平比较,差异均有统计学意义(均P<0.05)。血清中IGF-1表达水平与Apgar评分的相关性(r=0.73,P<0.01);血清中HSP70表达水平与Apgar评分的相关性(r=-0.61,P<0.01)。血清中IGF-1、HSP70预测新生儿窒息的AUC值分别为0.123(95%CI:0.054~0.192,P<0.01)和0.803(95%CI:0.731~0.875,P<0.01)。血清中IGF-1界值为14.17 ng·m L-1,灵敏度63.50%,特异度94.00%;血清中HSP70界值12.90 ng·m L-1,灵敏度83.30%,特异度68.00%。结论血清中IGF-1、HSP70的表达水平与新生儿窒息密切相关,血清中IGF-1、HSP70可作为新生儿窒息诊断的早期参考指标。

Objective To investigate the correlation between insulin-like growth factor-1 （IGF-1）, heat shock protein 70 （HSP70） and neonatal asphyxia and its reference value in asphyxia diagnosis. Methods A total of 146 full-term neonates were selected in our obstetrical department from November 2013 to May 2016. The mild asphyxia group was 51 cases and the severe group was 45 cases, at the same time normal delivery of newborns 50 cases were chosen as control group. The blood of umbilical artery （2 mL） was extracted immediately after delivered. The serum level of IGF-1 and HSP70 were detected by ELISA. Results The IGF-1 （ HSP70 ） levels of groups were statistically significant compared with each other （ all P 〈 0.05）. Correlation analysis showed that the serum level of IGF-1 was negatively correlated with Apgar score（r =0.73, P 〈0.01 ）. However, the serum level of HSPT0 was positively correlated with Apgar score （r = -0.61, P 〈0.01 ）. The areas under receiver operating characteristic of IGF-1,HSP70 levels to predict asphyxia were 0. 123（95% CI：0. 054 -0. 192,P 〈 0.01） and 0. 803 （95% CI：0. 731 - 0. 875,P 〈 0.01）, respectively. The test indicators are as follows： serum IGF-1 boundary value of 14.17 ng .mL-1 ,sensitivity 63.50% and speciality rate 94.00% ; Serum HSP70 boundary value of 12.90 ng .mL-1 ,sensitivity 83.30%and speciality rate 68.00%. Conclusion The serum level of IGF-1 and HSP70 were correlated with neonatal asphyxia ,which could be used asthe early diagnosis indicators of neonatalasphyxia.