血清tau蛋白、NGF、BNP在缺血缺氧性脑病患儿中的表达及与神经系统发育的相关性

Expression of serum tau protein, NGF and BNP in children with hypoxic ischemic encephalopathy and its correlation with nervous system development

目的研究血清tau蛋白、神经生长因子(NGF)、脑钠肽(BNP)在缺血缺氧性脑病(HIE)患儿中的表达及与神经系统发育的相关性。方法回顾性分析2017年2月至2018年10月暨南大学附属深圳市宝安区妇幼保健院妇产科收治的46例HIE新生儿(HIE组),按疾病严重程度分为轻度12例,中度18例,重度16例。选择同期分娩的健康新生儿40例作为对照组。分别于出生第7天时采用酶联免疫吸附试验测定血清tau蛋白、NGF、BNP水平,出生第7、14、28天进行新生儿神经行为(NBNA)评分,于出生第3、6个月时采用婴幼儿发育量表检测智力发育指数(MDI)、运动发育指数(PDI)。采用Pearason分析HIE患儿血清tau蛋白、NGF、BNP与NBNA评分、MDI、PDI的相关性。结果HIE组血清tau蛋白、BNP水平明显高于对照组,NGF水平明显低于对照组,差异有统计学意义(P<0.05);不同程度HIE患儿血清tau蛋白、BNP水平随疾病严重程度变化而升高,NGF水平随疾病严重程度变化而降低(P<0.05)。HIE组出生第7、14、30天NBNA评分明显低于对照组,HIE轻度、中度及重度患儿NBNA评分随着疾病严重程度变化而降低,出生第7、14、30天NBNA评分均明显低于对照组(P<0.05)。HIE组出生第3个月、6个月MDI、PDI指数明显低于对照组,轻度、中度及重度患儿MDI和PDI指数随着疾病严重程度变化而降低,出生第3个月、6个月MDI、PDI指数均明显低于对照组(P<0.05)。血清tau蛋白、BNP与NBNA评分呈负相关性(P<0.05),NGF与NBNA评分呈正相关性(P<0.05);血清tau蛋白、NGF、BNP与MDI、PDI呈负相关性(P<0.05)。结论血清tau蛋白、BNP水平变化随着HIE疾病严重程度升高,NGF水平变化随着HIE疾病严重程度降低,且与HIE患儿神经系统发育密切相关。

Objective To study the expression of serum tau protein,nerve growth factor(NGF)and brain natriuretic peptide(BNP)in children with hypoxic ischemic encephalopathy(HIE)and its correlation with nervous system development.Methods From February 2017 to October 2018,46 cases of HIE newborns(HIE group)admitted to the Department of Obstetrics and Gynecology at Shenzhen Baoan District Maternal and Child Health Hospital,Jinan University,were retrospectively analyzed,including mild(n=12),moderate(n=18)and severe(n=16).Another 40 healthy newborns delivered were used as the control group.Serum tau protein,NGF and BNP levels were measured by enzyme-linked immunosorbent assay on the 7th day of birth,and neonatal behavioral neurological assessment(NBNA)was performed on the 7th,14th and 28th day of birth.At the 3rd and 6th month of birth,the infant development scale was used to detect the mental development index(MDI)and psychomotive development index(PDI).Peason analysis was used to analyze the correlation between serum tau protein,NGF,BNP and NBNA score,MDI and PDI in children with HIE.Results The levels of serum tau protein and BNP in the HIE group were significantly higher than those in the control group,and the level of NGF was significantly lower than that in the control group,the differences were statistically significant(P<0.05).The levels of tau protein,and BNP in HIE group increased with the severity of the disease,and were higher than those in control group(P<0.05);The levels of NGF in HIE group decreased with the severity of the disease,and were lower than those in control group(P<0.05).NBNA score in HIE group on the 7th,14th and 30th day of birth were significantly lower than those of control group,the NBNA scores decreased with the severity of the disease,and were all significantly lower than those of the control group.The MDI and PDI indexes in the 3rd and 6th months of the HIE group were significantly lower than those of the control group.The MDI and PDI indexes of mild,moderate and severe children decreased with the severity of the disease,and were significantly lower than those of the control group(P<0.05).The serum tau protein,BNP and NBNA score were negatively correlated(P<0.05),NGF and NBNA score were positively correlated(P<0.05);tau protein,NGF,BNP and MDI,PDI were negatively correlated(P<0.05).Conclusion The changes of serum tau protein and BNP levels increase with the severity of HIE disease,and changes of NGF levels decrease with the severity of HIE disease,and are closely related to the development of the nervous system in children with HIE.