新生儿脑损伤对外周血脑红蛋白水平影响的Meta分析

Meta-analysis of neonatal brain injury on neuroglobin levels

目的：系统评价脑红蛋白在新生儿脑损伤中的预测价值。方法：以“neuroglobin”，“braininjury”为检索词，通过计算机检索Cochmne图书馆、PubMed、Embase、WebofScience等数据库，以“脑红蛋白”、“脑损伤”为检索词，联合检索中国知网期刊全文数据库和万方数据库(从建库至2016年3月20日），获得脑损伤对生物体液中脑红蛋白水平影响相关的文献，对纳人文献逐个进行质量评价、风险评估和资料提取,以生物体液中脑红蛋白的水平作为评价标准。采用RevMan5.2软件对数据进行统计分析。结果：共检索到324篇文献，纳人5篇,研究内容均与新生儿缺氧缺血相关联,其中有3篇与新生儿缺氧缺血性脑病（hypoxic-ischemicencephalopathy,HIE)有关,1篇与早产儿脑室周围白质软化（periventricularleukomalacia,PVL)有关,1篇与胎儿宫内窘迫有关。Meta分析结果显示,与对照组相比，不同程度的HIE均可引起外周血中脑红蛋白水平升高，轻度HIE中脑红蛋白水平合并标准化均数差（SMD)=2.71(95%C/:1.29~4.13,_P<0.01),中度HIE中脑红蛋白水平合并SMD=12.23(95%C/:8.33~16.13,/3<0.01),重度HIE中脑红蛋白水平合并SMD=13.25(95%C/:8.48~18.02，P<0.01);与对照组相比，早产儿PVL及宫内窘迫导致的脑损伤可引起外周血中脑红蛋白水平升高，脑红蛋白水平合并SMD=4.67(95%C/:2.55~6.78,P<0.01)。结论：外周血脑红蛋白水平对新生儿缺氧缺血性脑损伤有一定的预测价值。

Objective : To evaluate the predictive value of neuroglobin ( Ngb ) in neonatal brain injury.Methods: All relevant studies were searched by Cochrane library, PubMed, Embase, Web of Science,CNKI and WanFang Database( from the date of database building to March 20, 2016) with the index words of neuroglobin and brain injury. Quality of the studies was assessed and the information was extracted one by one. Ngb levels in biological fluid were chosen as the evaluation criteria. Then the Meta-analysis wasperformed by Review Manager version 5.2. Results: A total of 324 documents retrieved for the evaluation,of which 5 included into the Meta-analysis, which were all associated with hypoxic-ischemic disease, including3 on hypoxic-ischemic encephalopathy ( HIE) , 1 on periventricular leukomalacia ( PVL) , 1 on fetaldistress. Compared with the control groups, varying degrees of HIE increased the levels of Ngb in serum.The difference between two groups was statistically significant, the combined volume of Ngb level in mildHIE SMD =2.71(95% C/:l . 29 ?4.13, P <0.01) , Ngb combined in moderate HIE SMD =12.23(95% C/:8.33 ?16.13, P <0.01) , Ngb combined in severe HIE SMD =13.25(95% C/:8. 48 ?18. 02, P <0.01);brain damage caused by PVL and fetal distress increased the Ngb levels in serum. The difference betweenstudy and control groups was statistically significant, Ngb combined SMD = 4.67(95% C/:2. 55 ?6.78,_P <0. 01). Conclusion: Serum Ngb has the predictive value in neonatal hypoxic-ischemic brain damage.