缺氧缺血性脑病新生儿血清NF-L、AQP9、FGL2水平表达与NABA评分的相关性研究OA
Correlation Study Between Serum NF-L,AQP9 and FGL2 Levels and NABA Scores in Neonatal Hypoxic-Ischemic Encephalopathy
目的 通过研究缺氧缺血性脑病(HIE)新生儿血清神经纤维轻链(NF-L)、水通道蛋白9(AQP9)、纤维蛋白原样蛋白2(FGL2)水平的变化,分析三者与新生儿行为神经评估(NABA)评分的相关性.方法 选取2022年1月～2024年7月山西省儿童医院收治的203例HIE患儿为研究组,根据病情程度分为轻度组(n=63)、中度组(n=81)和重度组(n=59),另选同期的健康新生儿203例为对照组,酶联免疫吸附试验(ELISA)检测血清NF-L、AQP9、FGL2水平,收集分析一般临床资料.受试者操作特征(ROC)曲线分析NF-L、AQP9、FGL2及NABA评分对新生儿重度HIE的诊断价值;Pearson法分析血清NF-L、AQP9、FGL2与NABA评分的相关性.结果 与对照组相比,研究组血清NF-L(14.78±1.67ng/ml vs 10.65±1.21ng/ml)、AQP9(61.82±6.29pg/ml vs 42.62±4.31pg/ml)、FGL2(189.69±20.26ng/ml vs 132.51±14.84ng/ml)水平显著升高,差异具有统计学意义(t=28.533、35.877、32.440,均P＜0.05);中度组、重度组血清NF-L(14.68±1.67ng/ml、18.62±2.03ng/ml),AQP9(63.51±6.44pg/ml、69.63±7.03pg/ml),FGL2(195.68±20.84ng/ml、210.65±22.36ng/ml)水平显著高于轻度组(11.32±1.33ng/ml、52.32±5.41pg/ml、162.35±17.55ng/ml),NABA(34.89±3.51 分、29.88±3.43 分)评分显著低于轻度组(36.54±1.52分),差异具有统计学意义(t中度组=4.616～16.729,t重度组=17.276～33.701,均P＜0.05);NF-L、AQP9、FGL2与NABA评分均呈负相关(r=-0.432、-0.421、-0.402,均P＜0.05);NF-L、AQP9、FGL2、NABA联合诊断患儿重度病情的曲线下面积(AUC)显著高于各项单独诊断,差异具有统计学意义(Z=2.066～3.307,均P＜0.05).结论 HIE患儿血清NF-L、AQP9、FGL2水平显著升高,与NABA评分相关,可能成为评估HIE患儿病情的标志物.
Objective To investigate the changes in serum levels of neurofilament light chain(NF-L),aquaporin 9(AQP9),and fi-brinogen-like protein 2(FGL2)in neonatal hypoxic-ischemic encephalopathy(HIE),and to analyze the correlation between the three markers and the neonatal behavioral neurological assessment(NABA)scores in affected infants.Methods From January 2022 to July 2024,203 infants with HIE admitted to Shanxi Children's Hospital were enrolled as the patient group.According to disease se-verity,they were assigned into mild group(63 cases),moderate group(81 cases)and severe group(59 cases).An additional 203 healthy neonates from the same period were selected as the control group.Serum NF-L,AQP9 and FGL2 levels were measured by ELISA.General clinical data were collected and analyzed.Receiver operating characteristic(ROC)curves were plotted to analyze the diagnostic value of NF-L,AQP9,FGL2 and NABA scores for severe HIE in neonates.Pearson correlation analysis method was used to assessed the correlation between serum NF-L,AQP9,FGL2 and NABA scores.Results Compared with the control group,the patient group exhibited significantly higher serum levels of serum NF-L(14.78±1.67 ng/ml vs 10.65±1.21 ng/ml),AQP9(61.82±6.29 pg/ml vs 42.62±4.31 pg/ml)and FGL2(189.69±20.26 ng/ml vs 132.51±14.84 ng/ml)(t=28.533,35.877,32.440,all P＜0.05).Serum levels of NF-L(14.68±1.67 ng/ml,18.62±2.03 ng/ml),AQP9(63.51±6.44 pg/ml,69.63±7.03 pg/ml)and FGL2(195.68±20.84 ng/ml,210.65±22.36 ng/ml)were significantly higher in the severe and moderate groups than those in the mild groups(11.32±1.33 ng/ml,52.32±5.41 pg/ml,162.35±17.55 ng/ml),while the NABA score(34.89±3.51,29.88±3.43)was significantly lower than that in the mild groups(36.54±1.52)(tmoderate group=4.616～16.729,tsevere group=17.276～33.701,all P＜0.05).NF-L,AQP9 and FGL2 levels were all negatively correlated with NABA scores(r=-0.432,-0.421,-0.402,all P＜0.05).The AUC for combined diagnosis of severe disease using NF-L,AQP9,FGL2 and NABA was significantly higher than that for individual markers(Z=2.066～3.307,all P＜0.05).Conclusions Serum levels of NF-L,AQP9,and FGL2 in neonates with HIE are greatly ele-vated and correlated with NABA score,potentially serving as biomarkers for assessing HIE severity.
李海霞;冀湧;王荣华
山西省儿童医院新生儿重症监护病房,太原 030000山西省儿童医院新生儿重症监护病房,太原 030000山西省儿童医院新生儿重症监护病房,太原 030000
医药卫生
新生儿缺氧缺血性脑病神经纤维轻链水通道蛋白9纤维蛋白原样蛋白2新生儿行为神经评估
neonatal hypoxic-ischemic encephalopathyneurofilament light chainaquaporin 9fibrinogen-like protein 2neonatal behavioral neurological assessment
《现代检验医学杂志》 2026 (2)
141-145,5
山西省卫生健康委员会科研课题项目(2022A117).
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