血清sLOX-1、cTnI及CK-MB检测在缺氧缺血性脑病诊断中的价值

Value of serum levels of sLOX-1,cTnI and CK-MB in diagnosis of hypoxic-ischemic encephalopathy

目的探讨缺氧缺血性脑病患儿血清可溶性血凝素样氧化低密度脂蛋白受体-1(sLOX-1)、心肌肌钙蛋白I(cTnI)及肌酸激酶同工酶(CK-MB)水平变化,及其与新生儿神经行为测评(NBNA)评分动态变化的相关性,以及在缺氧缺血性脑病诊断中的价值。方法选择2017年2月至2019年10月该院诊治的120例缺氧缺血性脑病新生儿作为观察组,根据缺氧缺血性脑病分度标准将患儿进一步分为轻度组(65例)、中度组(38例)和重度组(17例),选择同期在该院妇产科出生的120例健康新生儿作为对照组。采用酶联免疫吸附试验法检测对照组出生后1 d及观察组出生后1、2、7 d血清sLOX-1、cTnI和CK-MB水平,比较观察组与对照组出生后1 d sLOX-1、cTnI和CK-MB水平,比较轻度组、中度组、重度组患儿在出生后1、2、7 d的血清sLOX-1、cTnI和CK-MB水平及NBNA评分。分析sLOX-1、cTnI、CK-MB水平与NBNA评分的相关性,以及联合检测的诊断价值。结果出生后1、2、7 d,轻度组、中度组、重度组患儿血清sLOX-1、cTnI和CK-MB水平依次升高,NBNA评分依次降低,两两比较,差异有统计学意义(P<0.05)。血清sLOX-1、cTnI和CK-MB水平与NBNA评分均呈负相关(r=—0.907、—0.855、—0.835,P<0.05)。血清sLOX-1、cTnI和CK-MB水平联合检测对缺氧缺血性脑病患儿的诊断价值明显高于各项指标单独检测。结论缺氧缺血性脑病患儿血清sLOX-1、cTnI和CK-MB水平随病情加剧逐渐升高,在缺氧缺血性脑病的诊断中具有一定临床价值。

Objective To investigate the changes of serum levels of soluble hemagglutinin-like oxidized low density lipoprotein receptor-1(sLOX-1),cardiac troponin I(cTnI)and creatine kinase isoenzyme(CK-MB)in newborns with hypoxic-ischemic encephalopathy,their correlation with the dynamic changes of Neonatal Behavioral Neurological Assessment(NBNA)score and value in diagnosis of hypoxic-ischemic encephalopathy.Methods A total of 120 newborns with hypoxic-ischemic encephalopathy diagnosed and treated in Huangshi Central Hospital of Edong Healthcare from February 2017 to October 2019 were selected as observation group and the newborns were further divided into mild group(65 cases),moderate group(38 cases)and severe group(17 cases)according to the grading standard.A total of 120 healthy newborns born in the department of obstetrics and gynecology during the same period were selected as control group.Serum sLOX-1,cTnI and CK-MB levels in control group(after birth 1 d)and observation group(after birth 1,2,7 d)were detected by enzyme-linked immunosorption method,serum sLOX-1,cTnI,CK-MB levels and NBNA scores of newborns between control group(1 d after birth)and observation group(1 d after birth),among mild group,moderate group and serve group after birth 1,2,7 d were compared.The relationships between sLOX-1,cTnI,CK-MB levels and NBNA score,the diagnosis of combined detection value were analyzed.Results After birth 1,2 and 7 d,serum sLOX-1,cTnI and CK-MB levels successively increased and NBNA scores successively decreased in the mild group,moderate group,severe group(P<0.05).Serum sLOX-1,cTnI and CK-MB levels negatively correlated with NBNA score(r=—0.907,—0.855,—0.835,P<0.05).The diagnostic value of combined detection of serum sLOX-1,cTnI and CK-MB levels in newborns with hypoxic-ischemic encephalopathy was significantly higher than those of individual detection.Conclusion Serum levels of sLOX-1,cTnI and CK-MB in newborns with hypoxic-ischemic encephalopathy gradually increase with the exacerbation of disease,which has certain clinical value in the diagnosis of hypoxic-ischemic encephalopathy.