高胆红素血症新生儿血清NPY、S100B蛋白、B/A比值与胆红素脑损伤的关系

Relationship between serum NPY,S100B protein,B/A ratio,and bilirubin brain injury in neonates with hyperbilirubinemia

目的研究高胆红素血症新生儿血清神经肽Y (NPY)、S100B蛋白、总胆红素/白蛋白(B/A)比值与胆红素脑损伤的关系。方法将咸阳市中心医院2016年1月至2018年12月期间收治的120例高胆红素血症新生儿纳入研究。将其按照脑损伤程度分为轻度组53例和中重度组67例,另取60例健康新生儿作为对照组。检测并比较三组新生儿的血清总胆红素(TSB)、NPY、S100B蛋白、B/A比值,对比三组新生儿行为神经测定量表(NBNA)评分。采用Pearson相关性分析法分析高胆红素血症新生儿血清NPY、S100B蛋白、B/A比值与TSB、NBNA评分的相关性。结果三组新生儿的性别、日龄、胎龄、出生体质量比较差异均无统计学意义(P>0.05);轻度组与中重度组新生儿的TSB、NPY、S100B、B/A比值明显高于对照组,且中重度组新生儿上述各项指标水平明显高于轻度组,差异均有统计学意义(P<0.05);轻度组与中重度组新生儿的各项NBNA评分明显低于对照组,且中重度组新生儿的各项NBNA评分明显低于轻度组,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,高胆红素血症新生儿血清NPY、S100B蛋白、B/A比值均与TSB呈正相关(r=0.523、0.582、0.601,P<0.05),均与NBNA评分呈负相关(r=-0.566、-0.594、-0.632,P<0.05)。结论高胆红素血症新生儿血清NPY、S100B蛋白、B/A比值与胆红素脑损伤密切相关,有可能成为早期预测高胆红素血症新生儿胆红素脑损伤的有效指标。

Objective To study the relationship between serum neuropeptide Y(NPY),S100B protein,total bilirubin/albumin(B/A)ratio,and bilirubin brain injury in neonates with hyperbilirubinemia.Methods A total of 120 neonates with hyperbilirubinemia who were admitted to Xianyang Central Hospital from January 2016 to December 2018 were included in the study.According to the degree of brain injury,they were divided into the mild group with 53 cases and the moderate and severe group with 67 cases.Another 60 healthy newborns were selected as the control group.Serum total bilirubin(TSB),NPY,S100B protein,and B/A ratio of neonates in the three groups were detected and compared,and NBNA scores among three groups were compared.Pearson correlation analysis was used to analyze the correlation between serum NPY,S100B protein,B/A ratio and TSB,Neonatal Behavioral Neurological Assessment(NBNA)scores in neonates with hyperbilirubinemia.Results The gender,day age,gestational age and birth mass of the neonates among the three groups showed no statistically significant difference(P>0.05).The TSB,NPY,S100B,and B/A ratio in the mild group and the moderate and severe group were all significantly higher than those in the control group,and the levels of the above-mentioned indicators in the moderate and severe group were all significantly higher than those in the mild group(P<0.05).All NBNA scores of neonates in the mild group and the moderate and severe group were significantly lower than those in the control group,and all NBNA scores of neonates in the moderate and severe group were significantly lower than those in the mild group(P<0.05).Pearson correlation analysis showed that serum NPY,S100B protein and B/A ratio of newborns with hyperbilirubinemia were positively correlated with TSB(r=0.523,0.582,0.601,P<0.05),and negatively correlated with NBNA score(r=-0.566,-0.594,-0.632,P<0.05).Conclusion The serum NPY,S100B protein and B/A ratio of newborns with hyperbilirubinemia are closely related to bilirubin brain injury,which may be an effective index for early prediction of bilirubin brain injury in neonates with hyperbilirubinemia.