HIE患儿血清tau蛋白、ACTA及尿酸表达与其病情、神经发育预后的关系

Relationship between the expression of serum tau protein,ACTA and uric acid and the severity of the disease,neurodevelopmental prognosis in children with hypoxic-ischemic encephalopathy of newborn

目的研究新生儿缺氧缺血性脑病(HIE)患儿血清tau蛋白、外源性激活素A(ACTA)及尿酸(UA)表达与其病情、神经发育预后的关系。方法收集2017年2月~2019年12月于我院诊治的108例HIE患儿为研究组,另选取同期健康的新生儿98例作为对照组。比较两组tau蛋白、ACTA及UA水平;对比不同病情、不同神经发育预后[采用格赛尔发育量表(Gesell)评估]HIE患儿tau蛋白、ACTA及UA水平,绘制ROC曲线分析上述因子水平对HIE患儿神经发育预后不良的预测价值。结果研究组tau蛋白、ACTA及UA水平较对照组高(P<0.05);不同病情HIE患儿tau蛋白、ACTA及UA水平比较:重度>中度>轻度(P>0.05);108例HIE患儿中,神经发育预后良好84例(77.78%),神经发育预后不良24例(22.22%),神经发育预后良好组tau蛋白、ACTA及UA水平明显低于神经发育预后不良组(P<0.05)。ROC曲线分析结果显示:tau蛋白、ACTA及UA水平对HIE患儿神经发育预后不良具有高预测价值,其中以联合检测的曲线下面积最大,为0.745;单项检测中以tau蛋白的曲线下面积最大,为0.658。结论HIE患儿血清tau蛋白、ACTA及UA呈高表达,可能与HIE患儿病情、神经发育预后密切相关,检测上述因子水平有助于评估患儿神经发育预后。

Objective To study the relationships between the expression of serum tau protein,activin A(ACTA)and uric acid(UA)and the severity of the disease,neurodevelopmental prognosis in children with hypoxic-ischemic encephalopathy of newborn(HIE).Methods The 108 children with HIE diagnosed and treated in our hospital from February 2017 to December 2019 were collected as the study group,and 98 healthy newborns during the same period were selected as the control group.The levels of tau protein,ACTA and UA between the two groups were compared.The levels of tau protein,ACTA and UA in children with HIE who had different disease severity and different neurodevelopmental prognosis[evaluated by Gesell development schedule(Gesell)]were compared.The ROC curve was drawn to analyze the value of the above factor levels in predicting the poor prognosis of children with HIE.Results The levels of tau protein,ACTA and UA in the study group were higher than those in the control group(P<0.05).The levels of tau protein,ACTA and UA in HIE children with disease severity were as follows:severe>moderate>mild(P>0.05).Among the 108 children with HIE,84(77.78%)had good neurodevelopmental prognosis and 24(22.22%)had a poor neurodevelopmental prognosis.The levels of tau protein,ACTA and UA in the good neurodevelopmental prognosis group were significantly lower than those in the poor neurodevelopmental prognosis group(P<0.05).ROC curve analysis results showed that the levels of tau protein,ACTA and UA have high value in predicting poor neurodevelopmental prognosis in children with HIE.Among them,the area under the curve of the combined test was the largest,which was 0.745.In the single test,the area under the curve of tau protein was the largest,which was 0.658.Conclusion Serum tau protein,ACTA and UA are highly expressed in children with HIE,which may be closely related to the severity of the disease and the prognosis of neurodevelopment in children with HIE.The detection of the levels of these factors can help assess the prognosis of neurodevelopment in children.