UCH-L1、S100β、GFAP在新生儿窒息性脑损伤中的表达及意义

Expression and significance of UCH-L1,S100β and GFAP in asphyxiated brain injury

目的探讨血清泛素羧基末端水解酶L1(ubiquitin carboxyl-terminal hydrolase L1,UCH-L1)、中枢神经特异蛋白(central nervous system specific protein,S100β)、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)在新生儿窒息性脑损伤中的表达水平及临床意义。方法选取2019年1月至2021年1月在浙江省金华市人民医院出生的84例窒息性脑损伤新生儿为观察组,另选取84例同时期出生的正常新生儿作为对照组,回顾性分析两组新生儿的临床资料,包括血清UCH-L1、S100β、GFAP表达水平及新生儿20项神经行为测定(neonatal behavioral neurological assessment,NBNA)评分等,分析血清UCH-L1、S100β、GFAP表达水平与NBNA的相关性。根据受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评估血清UCH-L1、S100β、GFAP水平和血清三项指标联合NBNA对新生儿窒息性脑损伤的诊断价值。结果①观察组患者的血清UCH-L1、S100β、GFAP表达水平均高于对照组,对照组的NBNA评分明显优于观察组,差异有统计学意义(P<0.05);②两组新生儿的血清UCH-L1、S100β、GFAP表达水平与NBNA均呈负相关(P<0.05);③ROC曲线显示UCH-L1、S100β、GFAP、NBNA和血清三项指标联合NBNA的曲线下面积分别为0.841、0.701、0.635、0.831和0.914,敏感度分别为88.1%、69.0%、45.2%、65.5%和84.5%,特异性分别为72.6%、70.2%、82.1%、92.9%、85.7%。结论窒息性脑损伤的新生儿血清UCH-L1、S100β、GFAP表达水平较正常新生儿明显升高,且与NBNA呈负相关,血清三项指标联合NBNA评分可较准确地诊断新生儿窒息性脑损伤。

Objective To investigate the expression level and significance of serum ubiquitin carboxyl-terminal hydrolase L1(UCH-L1),central nervous system specific protein(S100β),glial fibrillary acidic protein(GFAP)in neonatal asphyxia brain injury.Methods A total of 84 newborns with asphyxial brain injury born in Jinhua People’s Hospital from January 2019 to January 2021 were selected as the observation group,and 84 normal newborns born in the same period were selected as the control group.The clinical data of the two groups were retrospectively analyzed,included the expression levels of serum UCH-L1,S100β,GFAP,and 20 behavioral neural tests(Neonatalbehavioral neurological assessment,NBNA)of newborns.The correlation between the expression levels of UCH-L1,S100βand GFAP in serum and NBNA was analyzed.The diagnostic value of serum UK-L1,S100β,GFAP and three serum indicators combined with NBNA in neonatal asphyxia brain injury was evaluated by receiver operating characteristic(ROC)curve.Results①The expression levels of UCH-L1,S100βand GFAP in serum of the observation group were higher than those of the control group,and the control group NBNA score of the control group was significantly better than that of the observation group,the difference was statistically significant(P<0.05).②The expressions of UCH-L1,S100βand GFAP in serum were negatively correlated with NBNA in both groups(P<0.05).③ROC curve showed that the areas under the curve of UCH-L1,S100β,GFAP,NBNA and three serum indicators combined with NBNA were 0.841,0.701,0.635,0.831 and 0.914,respectively;sensitivity was 88.1%,69.0%,45.2%,65.5%and 84.5%;specificity was 72.6%,70.2%,82.1%,92.9%and 85.7%(P<0.05).Conclusion The expression levels of serum UCH-L1,S100βand GFAP in neonates with asphyxia brain injury were significantly higher than those in normal neonates,and were negatively correlated with NBNA.The three serum indexes combined with NBNA score can accurately diagnose neonatal asphyxial brain injury and provide reference for clinical treatment.