血浆少突胶质细胞髓鞘糖蛋白水平变化在诊断早产儿脑损伤中的价值

Changes in plasma odendmcyte-myelin glycoprotein levels for the diagnosis of brain injury in premature infants

目的通过测定神经元特异性烯醇化酶(neuron specific enolase,NSE)和少突胶质细胞髓鞘糖蛋白(odendmcyte-myelin glycoprotein,Omgp)水平,探讨其在早产儿脑损伤中的诊断价值。方法选取2019年1—12月在淮安市妇幼保健院新生儿医学中心住院治疗的80例早产儿,根据颅脑B超及MRI结果,按有无脑损伤分为脑损伤组(40例)及无脑损伤组(40例)。收集研究对象出生后6 h、72 h、7 d的血液标本,采用ELISA法测定NSE、Omgp水平,分析其对早产儿脑损伤的诊断价值。结果(1)脑损伤组生后6 h、72 h、7d NSE、Omgp水平较无脑损伤组显著升高。(2)早产儿脑损伤组生后6 h Omgp水平的ROC曲线下面积最大,为0.952,约登指数为0.813,灵敏度为87.50%,特异度为93.75%,对应的最佳阈值为57.971,阳性预测值97.22%,阴性预测值75.03%,高于NSE。(3)生后6 h、72 h、7 d Omgp水平与矫正胎龄40周NBNA评分负相关,相关系数分别为r=-0.728、-0.732、-0.752,均P<0.01;生后6 h、72 h及7 d NSE与NBNA评分无明显相关性(均P>0.05)。结论生后6 h NSE、Omgp水平可以作为BIPI的潜在诊断标志物,其中Omgp水平诊断准确率较高。生后6 h、72 h、7 d Omgp水平可能是预测BIPI预后的良好生物标志物。

Objective To investigate the relationship between brain injury and plasma odendmcyte-myelin glycoprotein(Omgp)levels and neuron-specific enolase(NSE)in premature infants,and analyze its clinical significance in premature infants with brain injury.Methods Total 80 cases of premature infants who were hospitalized in the Neonatal Medical Centre of Huai’an Maternal and Child Health Hospital from January 2019 to December 2019 were included in the study.According to the results of craniocerebral imaging,all infants were divided into brain injury group and non-brain injury group.Blood samples were obtained at 6,72 and 168 h after birth.Levels of NSE and Omgp were detected via ELISA.The predictive value of plasma NSE and Omgp for brain injury in premature infants(BIPI)was analysed.Results(1)The NSE and Omgp levels in the brain injury group were significantly higher than that in the non-brain injury group at 6,72 and 168 h after birth.(2)The area under ROC curve of OMgp level at 6 h after birth was the largest,which was 0.952,Yoden index was 0.813,sensitivity was 87.50%,specificity was 93.75%.The corresponding optimal threshold was 57.971,positive predictive value was 97.22%,and negative predictive value was 75.03%,which was higher than NSE.(3)The levels of Omgp at 6,72 and 168 h were significantly negatively correlated with the NBNA score at 40 weeks of corrected gestational age(r=-0.728,-0.732 and-0.752,respectively;all P<0.01).Levels of NSE had no significant correlation with prognosis at 6,72 and 168 h after birth(all P>0.05)but could predict the prognosis.Conclusion Levels of NSE and Omgp at 6 h after birth are all correlated with BIPI and can be used as potential diagnostic markers.The diagnostic accuracy of Omgp level is higher.The Omgp levels at 6,72 and 168 h after birth may be a good biomarker for predicting BIPI prognosis.