血清亲环素A、CD147与早产儿脑损伤的关系

Relationship of Serum Cyclophilin A and CD147 with Brain Injury in Preterm Infants

目的 探讨血清亲环素A(cyclophilin A,CyPA)、CD147水平与早产儿脑损伤(brain injury in premature infants, BIPI)的关系。方法 选取2019年11月~2021年7月武汉大学人民医院新生儿重症监护病房(neonatal intensive care unit, NICU)收治的胎龄≤34周早产儿65例,留取生后1、3、7天时血液样本并采用酶联免疫吸附测定法(ELISA)检测血清CyPA、CD147水平。根据颅脑影像学检查结果有无脑损伤及脑损伤性质分为脑室周围白质软化(periventricular leukomalacia, PVL)组、脑室周围-脑室内出血(periventricular hemorrhage-intraventricular hemorrhage, PVH-IVH)组及无脑损伤组。比较3组轻度与重度脑损伤之间早产儿血清CyPA、CD147水平。结果 生后第1、3、7天,PVL组、PVH-IVH组、无脑损伤组早产儿血清CyPA、CD147水平比较,差异均有统计学意义(P均<0.05),各时间点PVL组均最高,无脑损伤组最低,PVH-IVH组居中。PVH-IVH及无脑损伤组生后第1、3、7天,CyPA、CD147水平呈下降趋势(P<0.05),PVL组CyPA、CD147水平生后第1天最高,生后第3天与第7天比较,差异无统计学意义(P>0.05)。生后第1、3、7天,重度PVH-IVH组及重度PVL组血清CyPA、CD147水平均明显高于轻度组(P均<0.05)。CyPA与CD147呈显著正相关。结论 血清CyPA、CD147水平有望成为早期预测BIPI的敏感标志物,有助于评估BIPI的严重程度。

Objective To explore the relationship of serum cyclophilin A(CyPA)and CD147 with brain injury in preterm infants. Methods A total of 65 premature infants with gestational age ≤34 weeks treated in the neonatal intensive care unit of the Renmin Hospital of Wuhan University from November 2019 to July 2021 were recruited. Blood samples were collected on the 1, 3, 7day after birth. The levels of serum CyPA and CD147 were detected by ELISA method. According to the results of cranial imaging examination, the premature infants were divided into periventricular leukomalacia(PVL)group, periventricular hemorrhage-intraventricular hemorrhage(PVH-IVH)group, and no brain damage group. The levels of serum CyPA and CD147 in preterm infants between the three groups, mild to severe brain injury were compared. Results At 1, 3, 7day after birth, the levels of serum CyPA and CD147 among no brain damage group, PVH-IVH group and PVL group were significantly different(P<0.05). The PVL group had the highest value at all the above time points, the g no brain damage group had the lowest value, and the PVH-IVH group was in the middle. The levels of serum CyPA and CD147 showed a downward trend at 1, 3, 7day after birth in PVH-IVH group and no brain damage group(P<0.05), while the levels of serum CyPA and CD147 in PVL group were the highest on 1 d after birth, and there was no statistical significance between 3and 7day after birth(P>0.05). The levels of serum CyPA and CD147 in severe PVH-IVH group and severe PVL group were significantly higher than those in the mild group at 1, 3, 7day after birth(P<0.05). CyPA and CD147 are significantly positively correlated. Conclusion The levels of serum CyPA and CD147 in preterm infants can be used as sensitive markers for early evaluation of brain injury, which can help determine the severity of brain injury in preterm infants.