血清MBP GFAP水平与新生儿缺氧缺血性脑病脑损伤程度的关系研究

Study on the relationship between serum MBP and GFAP levels and the severity of brain damage in neonates with hypoxic ischemic encephalopathy

目的分析血清髓鞘碱性蛋白(MBP)、胶质纤维酸性蛋白(GFAP)水平与新生儿缺氧缺血性脑病(HIE)脑损伤严重程度的关系。方法回顾分析2018-02—2019-10平顶山市第一人民医院121例HIE患儿的临床资料,根据脑损伤严重程度分为轻中度组和重度组。比较轻中度组与重度组血清MBP与GFAP水平,分析可能影响HIE病情的相关因素,Logistic回归分析明确导致HIE损伤程度的危险因素。采用Spearman相关系数分析患儿血清MBP、GFAP水平与HIE临床分度的关系。结果重度组血清MBP、GFAP水平高于轻中度组(P<0.05)。单因素分析显示重度组产程异常和羊水污染占比高于轻中度组(P<0.05)。Logistic回归分析显示产程异常、羊水污染、MBP、GFAP是导致HIE的危险因素(P<0.05)。Spearman相关性分析显示HIE患儿血清MBP、GFAP水平与HIE临床分度呈正相关(r=0.816、0.835,P<0.001)。结论血清MBP、GFAP水平可反映HIE患儿脑损伤严重程度,且其是影响HIE病情的危险因素,两者表达水平与HIE患儿脑损伤严重程度呈正相关。

Objective To analyze the relationship between the levels of serum myelin basic protein(MBP)and glial fibrillary acidic protein(GFAP)and the severity of neonatal ischemic hypoxic encephalopathy(HIE)brain injury.Methods The clinical data of 121 children with HIE admitted to the Department of Neonatology in the First People's Hospital of Pingdingshan from February 2018 to October 2019 were reviewed.According to the severity of HIE brain injury,they were divided into mild to moderate group and severe group.Compared the levels of serum MBP and GFAP between HIE mild-moderate group and severe group,single factor analysis may affect the related factors of HIE disease,logistic regression analysis clarified the risk factors leading to HIE severe brain injury.Spearman correlation coefficient method was used to calculate serum MBP,The correlation coefficient between GFAP level and HIE clinical scale.Results The levels of serum MBP and GFAP in severe HIE group were higher than mild to moderate group(P<0.05).According to univariate analysis,the proportion of abnormal labor and amniotic fluid pollution in the severe HIE group was higher than that in the mild to moderate group(P<0.05).Logistic regression analysis of abnormal labor,amniotic fluid pollution,MBP,GFAP are the risk factors of severe HIE(P<0.05).Spearman correlation analysis showed that serum MBP and GFAP levels in children with HIE were positively correlated with the clinical scale of HIE(r=0.816,0.835,P<0.001).Conclusion Serum MBP and GFAP levels can reflect the severity of brain injury in children with HIE,and are risk factors affecting the condition of HIE.The expression levels of the two are positively correlated with the severity of brain injury in children with HIE.