血清BNP及γ-GT水平与新生儿窒息神经预后的相关性研究

Research on the Correlation Between Serum BNPγ-GT Levels and Neural Prognosis in Asphyxia Neonates

目的:研究血清脑钠肽(BNP)及γ-谷氨酰转肽酶(γ-GT)水平与新生儿窒息神经预后的相关性。方法:选取2017年2月至2019年6月于本院收治的128例窒息新生儿,其中轻度组76例,重度组52例,另选30例健康新生儿作为对照。比较三组的血清BNP、γ-GT水平,以及不同时间新生儿行为神经评定量表(NBNA)评分,并用ROC曲线分析血清BNP、γ-GT水平对轻度、重度窒息的鉴别效能,用Pearson法分析BNP、γ-GT表达水平与NBNA评分的相关性。结果:三组新生儿BNP、γ-GT水平比较,差异有统计学意义(P<0.05);其中轻度组、重度组患儿BNP、γ-GT水平均高于对照组(P<0.05);重度组BNP、γ-GT水平均高于轻度组(P<0.05);BNP鉴别轻度、重度窒息的曲线下面积(AUC)为0.885(95%CI:0.827~0.943,P<0.001);γ-GT鉴别轻度、重度窒息的的AUC为0.847(95%CI:0.777~0.917,P<0.001);不同窒息程度及对照组新生儿的NBNA评分比较,差异有统计学意义(P<0.05);不同时间点三组的NBNA评分存在显著差异,NBNA评分逐渐上升,重度组新生儿上升幅度最大(P<0.05);重度组BNP、γ-GT表达水平与第1、7天NBNA评分呈负相关(r=-0.318,r=-0.352,P<0.05)和(r=-0.303,r=-0.380,P<0.05)。结论:血清BNP、γ-GT有效鉴别新生儿窒息程度,且重度窒息新生儿第1、7天的BNP、γ-GT表达水平与神经预后存在相关性,窒息程度愈严重,BNP、γ-GT表达水平越高,NBNA评分越低。

Objective:To study the correlation between serum brain natriuretic peptide(BNP),γ-glutamyl transpeptidase(γ-GT)levels and neural prognosis in asphyxia neonates.Methods:A total of 128 asphyxia neonates who were admitted to the hospital from February 2017 to June 2019 were enrolled,including 76 cases in mild group and 52 cases in severe group.Another 30 healthy neonates were enrolled as control group.The levels of serum BNP andγ-GT,and scores of neonatal behavioral neurological assessment(NBNA)were compared among the three groups.The efficiency of serum BNP andγ-GT levels for distinguishing mild asphyxia from severe asphyxia was analyzed by ROC curves.The correlation between expression level of BNP andγ-GT and NBNA score was analyzed by Pearson method.Results:There were significant differences in levels of BNP andγ-GT among the three groups(P<0.05).The levels of BNP andγ-GT were the highest in severe group,followed by mild groups and control group(P<0.05).The area under the curve(AUC)values for BNP andγ-GT to identify mild and severe asphyxia were 0.885(95%CI:0.827-0.943,P<0.001)and 0.847(95%CI:0.777-0.917,P<0.001),respectively.There were significant differences in NBNA scores of newborns with different degrees of asphyxia compared with control group(P<0.05).There were significant differences in NBNA scores among the three groups at different times,and the NBNA scores gradually increased,whose increase was more significant in severe group(P<0.05).The expression levels of BNP andγ-GT were negatively correlated with NBNA scores on the first day and 7th day in severe group[(r=-0.318,r=-0.352,P<0.05),(r=-0.303,r=-0.380,P<0.05)].Conclusion:Serum BNP andγ-GT can effectively distinguish the severity of neonatal asphyxia.The expression levels of BNP andγ-GT on the first day and 7th day are correlated with neural prognosis in severe asphyxia neonates.The more severe the asphyxia,the higher the expression levels of BNP andγ-GT,and the lower the NBNA score.