足月窒息新生儿血清鸢尾素和ADAMTS-13水平变化及其对神经功能预后的影响

Changes of serum Irisin and Von will brand factor-cleaving protease in full-term asphyxiated newborns and their effects on neurological prognosis

目的探讨足月窒息新生儿血清鸢尾素和血管性血友病因子裂解酶(ADAMTS-13)水平变化及其对神经功能预后的影响。方法选取我院2019年8月至2021年2月收治的足月窒息新生儿87例作为窒息组,同期纳入87例健康新生儿作为对照组。分析两组血清鸢尾素、ADAMTS-13水平变化。所有患儿均随访至3月龄,分析两组神经功能发育与血清鸢尾素、ADAMTS-13的关系。采用Spearman分析血清鸢尾素、ADAMTS-13与新生儿神经行为(NBNA)评分的关系;绘制ROC曲线图分析相关指标对足月窒息新生儿不良预后的预测效能。结果窒息组血清鸢尾素、ADAMTS-13水平均低于对照组(P<0.05);神经发育落后组血清鸢尾素、ADAMTS-13水平均低于神经发育良好组(P<0.05);经Spearman分析发现,血清鸢尾素与ADAMTS-13呈正相关关系(r=0.447、P=0.000);血清鸢尾素、ADAMTS-13与NBNA均呈正相关关系(r=0.557、0.513,P<0.05);ROC曲线分析发现,二者联合预测患儿神经功能预后的AUC为0.910(0.844~0.978),分别高于血清鸢尾素(AUC=0.782)、ADAMTS-13(AUC=0.649)单独预测患儿神经功能预后的AUC(P<0.05)。结论足月窒息新生儿血清鸢尾素和ADAMTS-13水平均下降,与足月窒息新生儿神经功能近期预后密切相关。血清鸢尾素和ADAMTS-13对足月窒息新生儿近期神经功能预后具有一定价值。

Objective To investigate the changes of serum Irisin and Von will brand factor-cleaving protease(ADAMTS-13)levels in full-term asphyxiated newborns and their effects on the prognosis of neurological function.Methods Totally 87 full-term asphyxia newborns treated in our hospital from August 2019 to February 2021 were selected as the asphyxia group(n=87);87 healthy newborns were included in the same period as the control group(n=87).The changes of serum Irisin and ADAMTS-13 levels in different groups were analyzed.All children were followed up to 3 months old to analyze the relationship between neurological development and serum Irisin and ADAMTS-13 in the two groups.Spearman was used to analyze the relationship between serum Irisin,ADAMTS-13 and NBNA score.The ROC curve was drawn to analyze the predictive efficacy of relevant indicators on the adverse prognosis of full-term asphyxia newborns.Results The levels of serum Irisin and ADAMTS-13 in asphyxia group were lower than those in control group(P<0.05),and they were lower in neurodevelopmental retardation group then in the good neurodevelopment group(P<0.05).Spearman analysis showed that there was a positive correlation between serum Irisin and ADAMTS-13(r=0.447,P=0.000).There was a positive correlation between serum Irisin,ADAMTS-13 and NBNA(r=0.557,0.513,P<0.05).ROC curve analysis showed that the AUC of the combined prediction of neurological prognosis was 0.910(0.844-0.978),which was higher than that of serum Irisin(AUC=0.782)and ADAMTS-13(AUC=0.649)alone(P<0.05).Conclusion The short-term prognosis of neonatal asphyxia in the full-term is closely related to the serum level of Irisin and ADAMTS-13,which are lower.Serum irisin and ADAMTS-13 have certain value in the short-term neurological prognosis of full-term asphyxia newborns.