血清HMGB1、IGF-1、NSE在新生儿低血糖脑损伤中的变化及应用价值

Changes of serum HMGB1,IGF-1 and NSE in neonatal hypoglycemia brain damage and its application value

目的探讨血清高迁移率族蛋白B1 (HMGB1)、胰岛素样生长因子-1 (IGF-1)、神经元特异性烯醇化酶(NSE)在新生儿低血糖脑损伤中的变化及应用价值,为新生儿低血糖脑损伤早期诊断提供指导。方法选取2015年10月-2016年10月河北燕达医院收治的128例低血糖新生儿根据脑部CT或MRI诊断结果将患儿分为单纯低血糖组68例及低血糖合并脑损伤组60例,另选取60例正常新生儿为对照组。应用ELISA法测定各组入院时血清HMGB1、IGF-1、NSE水平,观察新生儿低血糖患儿不同入院时间血清HMGB1、IGF-1、NSE变化情况;应用受试者特异曲线(ROC)分析血清HMGB1、IGF-1、NSE在低血糖脑损伤中的应用价值。结果低血糖合并脑损伤组患儿入院时血清儿HMGB1、IGF-1、NSE水平显著高于单纯低血糖组及对照组,单纯低血糖组患儿显著高于对照组,差异均有统计学意义(P<0. 05)。随着低血糖新生儿病情的改善及转归,患儿血清HMGB1、IGF-1、NSE水平显著下降,低血糖脑损伤预后良好组血清HMGB1、IGF-1、NSE水平低于预后不良组,差异均有统计学意义(P<0. 05)。血清HMGB1、IGF-1、NSE联合诊断新生儿低血糖脑损伤中ROC曲线下面积(AUC)为0. 812>HMGB1、IGF-1、NSE单独诊断新生儿低血糖脑损伤AUC 0. 742、0. 719、0. 752。结论血清HMGB1、IGF-1、NSE在新生儿低血糖脑损伤时水平显著升高,且随着患儿病情转归其水平显著下降,可作为新生儿低血糖脑损伤的早期诊断指标。

Objective To investigate the changes of serum the levels of high mobility group box-1 protein （ HMGB1 ）, insulin-like growth factor-1 （IGF-1 ） and neuron-specific enolase （NSE） in neonatal hypoglycemic brain injury and its application value, in order to provide guidance for early diagnosis of neonatal hypoglycemia brain injury. Methods 128 cases of neonates with hypoglycemia were selected according to the diagnosis of brain CT or MRI from October 2015 to October 2016. The patients were divided into simple hypoglycemia （n= 68） and hypoglycemia with brain injury （n=60） . The levels of serum HMGB1, IGF-1 and NSE in the neonates with hypoglycemia were measured by ELISA, and the changes of serum levels of HMGB1, IGF-1, NSE were measured at different hospital admission times. The serum levels of HMGB1, IGF- 1 and NSE were measured by ROC in hypoglycemic brain injury. Results The levels of serum MGB1, IGF-1 and NSE in hypoglycemia combined with brain injury group were significantly higher than that in simple hypoglycemia group and con- trol group, while the simple hypoglycemia group were higher than control group, the difference was statistically significant （ P〈0. 05 ） . With the improvement of neonatal hypoglycemia, the serum levels of HMGB1, IGF-1 and NSE in the neonates with hypoglycemia were signifi- cantly decreased. The serum levels of HMGB1, IGF-1 and NSE in the group with good prognosis were lower than those with poor prognosis, the difference was statistically significant （P〈0. 05 ） . The area under the curve （AUC） of serum HMGB1, IGF-1 and NSE in neonatal hy- poglycemia brain injury was 0. 812, which greater than that HMGB1, IGF-1 and NSE, respectively. The ROC curve analysis showed that AUC 0. 742, 0. 719, 0. 752. Conclusion The levels of HMGB1, IGF-1 and NSE in serum of neonates with hypoglycemia are significant- ly increased, and declined significantly with the recovery of the disease, can be used as early diagnostic indicators for neonatal hypoglycemia brain injury ...