单核细胞趋化蛋白-1、可溶性细胞黏附分子-1诊断新生儿缺氧缺血性脑病的价值

Values of monocyte chemoattractant protein-1 and soluble cell adhesion molecule-1 in diagnosis of neonatal hypoxic ischemic encephalopathy

  • 摘要:
      目的  探讨单核细胞趋化蛋白-1(MCP-1)、可溶性细胞黏附分子-1(sICAM-1)诊断新生儿缺氧缺血性脑病(HIE)的价值。
      方法  选择102例HIE患儿以及在医院娩出的54例健康新生儿作为研究对象,分别纳入HIE组与对照组。比较2组新生儿血清MCP-1、sICAM-1水平,比较不同病情严重程度HIE新生儿血清MCP-1、sICAM-1水平,分析血清MCP-1、sICAM-1水平与病情严重程度的相关性。
      结果  HIE组新生儿血清MCP-1、sICAM-1水平高于对照组,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线显示,血清MCP-1、sICAM-1诊断HIE的曲线下面积(AUC)分别为0.828、0.794, 联合诊断HIE的AUC为0.903。随着病情的加重,轻度、中度、重度HIE患儿血清MCP-1、sICAM-1水平呈升高趋势,差异均有统计学意义(P<0.05)。Spearman相关性分析显示,血清MCP-1、sICAM-1水平与病情严重程度呈显著正相关(r=0.618、0.527, P<0.05)。
      结论  血清MCP-1、sICAM-1可能参与介导HIE患儿脑损伤免疫炎症病理生理过程,并与患儿病情严重程度关系密切,在诊断HIE患儿病情中具有一定的价值。

     

    Abstract:
      Objective  To explore the values of monocyte chemoattractant protein-1 (MCP-1) and soluble cell adhesion molecule-1 (sICAM-1) in the diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE).
      Methods  A total of 102 neonates with HIE and 54 healthy neonates were selected as the research subjects, and they were included in HIE group and control group respectively. Levels of serum MCP-1 and sICAM-1 of neonates were compared between two groups, the levels of serum MCP-1 and sICAM-1 were compared in neonates with different severities of HIE, and the correlations of the levels of serum MCP-1 and sICAM-1 with the severity of HIE were analyzed.
      Results  The levels of serum MCP-1 and sICAM-1 in the HIE group were significantly higher than those in the control group (P < 0.05). The receiver operating characteristic (ROC) curve showed that the values of area under the curve (AUC) of serum MCP-1 and sICAM-1 in the diagnosis of HIE were 0.828 and 0.794 respectively, and the AUC of combined diagnosis of HIE was 0.903. With the aggravation of the disease, the levels of serum MCP-1 and sICAM-1 in children with mild, moderate and severe HIE increased gradually significantly (P < 0.05). Spearman correlation analysis showed that the levels of serum MCP-1 and sICAM-1 were significantly positively correlated with the severity of the disease (r=0.618, 0.527, P < 0.05).
      Conclusion  Serum MCP-1 and sICAM-1 may be involved in mediating the pathophysiological process of immune inflammation of brain injury in children with HIE, and are closely related to the severity of the disease, so the two indexes have certain values in diagnosing condition of the disease in children with HIE.

     

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