新生儿缺氧缺血性脑病血清HMGB1、脂蛋白a水平变化及临床意义

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摘要目的探讨新生儿缺氧缺血性脑病血清高速泳动族蛋白B1（HMGB1）、脂蛋白a水平变化及临床意义。方法选择2018年1月—2020年3月河北省秦皇岛市妇幼保健院（以下简称“我院”）诊治的105例缺氧缺血性脑病新生儿作为观察组，根据分度标准将其进一步分为轻度组57例，中度组33例和重度组15例，选择同期在我院妇产科出生的53名健康新生儿作为对照组。比较不同组血清HMGB1、脂蛋白a水平及新生儿神经行为测评（NBNA）评分，分析血清HMGB1、脂蛋白a水平与NBNA评分的相关性，采用受试者工作特征（ROC）曲线评估血清HMGB1、脂蛋白a水平对缺氧缺血性脑病新生儿的诊断价值。结果观察组血清HMGB1和脂蛋白a水平显著高于对照组，差异均有统计学意义（均P ＜ 0.05）。重度组血清HMGB1、脂蛋白a水平高于中度组和轻度组，而NBNA评分低于中度组和轻度组，差异均有统计学意义（均P ＜ 0.05）；中度组血清HMGB1、脂蛋白a水平高于轻度组，而NBNA评分低于轻度组，差异均有统计学意义（均P ＜ 0.05）。ROC曲线分析结果示，血清HMGB1水平（r = -0.9123，P ＜ 0.05）、脂蛋白a水平（r = -0.9045，P ＜ 0.05）均与NBNA评分呈负相关。血清HMGB1、脂蛋白a联合检测对新生儿缺氧缺血性脑病的诊断价值高于各项单独检测。结论缺氧缺血性脑病新生儿血清HMGB1、脂蛋白a水平升高，且与病情严重程度相关，可作为诊断缺氧缺血性脑病的分子标志物。

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	姜淑萍朱洪斌刘芳才海燕冯宁宁闫爱霞

关键词 ：缺氧缺血性脑病, 高速泳动族蛋白B1, 脂蛋白a, 诊断

Abstract：Objective To investigate of levels changes of serum high mobility group box-1 protein (HMGB1) and lipoprotein a in newborns with hypoxic ischemic encephalopathy and its clinical significances. Methods A total of 105 newborns with hypoxic ischemic encephalopathy which diagnosed and treated in Maternity and Child Care Center of Qinhuangdao, Hebei Province (referred to as “our hospital” for short) from January 2018 to March 2020 were selected as the observation group. According to the grading standard, they were further divided into mild group (57 cases), moderate group (33 cases) and severe group (15 cases). Fifty-three healthy newborns born in the department of obstetrics and gynecology of our hospital during the same period were selected as the control group. Serum levels of HMGB1, lipoprotein a and neonatal behavioral neurological assessment (NBNA) scores were compared in different group. The correlation between serum levels of HMGB1, lipoprotein a and NBNA score was analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of serum HMGB1 and lipoprotein a levels in newborns with hypoxic ischemic encephalopathy. Results The levels of serum HMGB1 and lipoprotein a in the observation group were significantly higher than those in the control group, and the differences were statistically significant (all P ＜ 0.05). The levels of serum HMGB1 and lipoprotein a in the severe group were higher than those in the moderate and mild groups, while the NBNA score was lower than that in the moderate group and mild group, with statistically significant differences (all P ＜ 0.05). The serum HMGB1 and lipoprotein a levels of the moderate group were higher than those in the mild group, while the NBNA score was lower than that in the mild group, with statistically significant differences (all P ＜ 0.05). Serum levels of HMGB1 (r = -0.9123，P ＜ 0.05) and lipoprotein a (r = -0.9045，P ＜ 0.05) were both negatively correlated with NBNA score. ROC curve analysis results showed that the combined detection of serum HMGB1 and lipoprotein a was more valuable in the diagnosis of newborns with hypoxic ischemic encephalopathy than the individual detection. Conclusion The serum levels of HMGB1 and lipoprotein a of newborns with hypoxic ischemic encephalopathy are increased and correlated with the severity of the disease, which can be used as molecular markers for the diagnosis of hypoxic ischemic encephalopathy.

Key words： Hypoxic ischemic encephalopathy High mobility group box-1 protein Lipoprotein a Diagnosis

基金资助:河北省医学科学研究重点课题计划项目（201801205）。

通讯作者: 闫爱霞（1973.5-），女，硕士，主任医师；研究方向：新生儿危重症及神经系统疾病。

作者简介: 姜淑萍（1983.2-），女，硕士；研究方向：新生儿科危重症及急救。

引用本文:

姜淑萍朱洪斌刘芳才海燕冯宁宁闫爱霞. 新生儿缺氧缺血性脑病血清HMGB1、脂蛋白a水平变化及临床意义[J]. 中国医药导报, 2021, 18(8): 25-28,49.
JIANG Shuping ZHU Hongbin LIU Fang CAI Haiyan FENG Ningning YAN Aixia. Changes of levels of serum HMGB1 and lipoprotein a in newborns with hypoxic ischemic encephalopathy and its clinical significances. 中国医药导报, 2021, 18(8): 25-28,49.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2021/V18/I8/25

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