[1]张　琦,姜　泓,冯慧玲.血清神经胶质原纤维酸性蛋白和泛素羧基末端水解酶-L1与足月儿缺氧缺血性脑病的关系[J].新乡医学院学报,2022,39(2):136-140.[doi:10.7683/xxyxyxb.2022.02.007]
　ZHANG Qi,JIANG Hong,FENG Huiling.Correlation of serum glial fibrillary acidic protein，ubiquitin carboxy terminal hydrolase-L1 and hypoxic-ischemic encephalopathy in term infants[J].Journal of Xinxiang Medical University,2022,39(2):136-140.[doi:10.7683/xxyxyxb.2022.02.007]
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血清神经胶质原纤维酸性蛋白和泛素羧基末端水解酶-L1与足月儿缺氧缺血性脑病的关系
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年2
页码:
136-140
栏目:
临床研究
出版日期:
2022-02-05

文章信息/Info

Title:
Correlation of serum glial fibrillary acidic protein，ubiquitin carboxy terminal hydrolase-L1 and hypoxic-ischemic encephalopathy in term infants
作者:
张　琦; 姜　泓; 冯慧玲
（延安大学附属医院新生儿科，陕西　延安　716000）
Author(s):
ZHANG Qi; JIANG Hong; FENG Huiling
(Department of Neonatology,Yan′an University Affiliated Hospital,Yan′an 716000,Shaanxi Province,China)
关键词:
神经胶质原纤维酸性蛋白; 泛素羧基末端水解酶-L1; 缺氧缺血性脑病; 足月儿
Keywords:
glial fibrillary acidic protein; ubiquitin carboxy terminal hydrolase-L1; hypoxic-ischemic encephalopathy; term infant
分类号:
R722.1
DOI:
10.7683/xxyxyxb.2022.02.007
文献标志码:
A
摘要:
目的　探讨血清神经胶质原纤维酸性蛋白（GFAP）、泛素羧基末端水解酶-L1（UCH-L1）与足月儿缺氧缺血性脑病（HIE）病情严重程度的关系。方法　选择2019年2月至2020年2月延安大学附属医院新生儿科收治的46例HIE足月儿为观察对象，根据病情程度分为轻度HIE组(n=13)、中度HIE组(n=21）和重度HIE组(n=12)；另选择同期在本院出生且无窒息及神经系统症状的30例足月儿为对照组。轻度HIE组患儿给予常规的三支持治疗（1.维持良好的通气功能；2.维持脑和全身良好的血流灌注；3.维持血糖在正常范围）和三对症治疗（1.控制惊厥；2.降低颅内压；3.消除脑干症状）；中、重度HIE患儿除了给予常规的三支持和三对症治疗外，同时于出生后 6~72 h期间给予头部亚低温治疗，维持肛温在 34~35 ℃。各组受试者均于出生第1、3、7天采集外周静脉血1.5～2.0 mL，置于干燥促凝管中，凝血后以3 200 r·min-1离心5 min ，取血清-70 ℃保存，采用酶联免疫吸附法检测血清GFAP、UCH-L1水平，比较各组受试者出生第1、3、7天血清GFAP、UCH-L1水平差异，并观察血清GFAP、UCH-L1水平与足月儿HIE病情严重程度的关系。结果　出生第3天，轻度HIE组患儿血清GFAP水平显著高于对照组（P<0.05）。出生第1、3、7天，中度HIE组、重度HIE组患儿血清GFAP、UCH-L1水平均显著高于对照组（P<0.05）。中度HIE组患儿出生第1、3、7天的血清UCH-L1水平及出生第7天的血清GFAP水平显著高于轻度HIE组，重度HIE组患儿出生第1、3、7天的血清GFAP、UCH-L1水平均显著高于轻度HIE组（P<0.05）。重度HIE组患儿出生第1、7天的血清UCH-L1水平及出生第1、3、7天的血清GFAP水平均显著高于中度HIE组（P<0.05）。中度HIE组、重度HIE组患儿出生第1、7天的血清GFAP水平显著高于出生第3天(P<0.05)。Spearman相关性分析显示，出生第1、3、7 天，血清GFAP 水平与HIE患儿的病情严重程度均呈正相关（r=0.740、0.526、0.902，P<0.05），血清UCH-L1水平与HIE患儿严重程度亦呈正相关（r=0.733、0.807、0.799，P<0.05）。结论　出生1周内，足月HIE患儿血清GFAP、UCH-L1水平与病情严重程度呈正相关，早期检测血清GFAP、UCH-L1水平对早期发现HIE并进行干预具有一定的指导意义。
Abstract:
Objective　To investigate the correlation of serum glial fibrillary acidic protein (GFAP),ubiquitin carboxy terminal hydrolase-L1 (UCH-L1) and severity of hypoxic-ischemic encephalopathy(HIE) in term infants.Methods　A total of 46 neonates with HIE admitted to Yan′an University Affiliated Hospital from February 2018 to February 2019 were selected as observation subjects,and they were divided into mild HIE group (n=13),moderate HIE group (n=21) and severe HIE group (n=12) according to the degree of illness;Another 30 full-term newborns without asphyxia and neurological symptoms were selected as the control group.The children in the mild HIE group were given routine three support treatment (1.the good ventilation function was maintained;2.the good blood perfusion was maintained in the brain and whole body;3.the blood glucose was maintained in the normal range) and three symptomatic treatment (1.control convulsion;2.reduce intracranial pressure;3.eliminate brainstem symptoms)；in addition to routine three support and three symptomatic treatment，the children with moderate and severe HIE were treated with mild head hypothermia during 6-72 hours after birth to maintain the anal temperature at 34-35 ℃.A total of 1.5-2.0 mL of peripheral venous blood was collected and placed in a dry coagulation promoting tube on the 1st,3rd and 7th day after birth;after coagulation,the blood was centrifuged at 3 200 r·min-1 for 5 minutes,the serum was taken and stored at -70 ℃;the levels of serum GFAP and UCH-L1 were detected by using enzyme-linked immunosorbent assay.The differences of serum GFAP and UCH-L1 levels on the 1st，3rd and 7th day after birth among each group were compared，and the relationship between serum GFAP，UCH-L1 levels and the severity of HIE in term infants was observed.Results　On the 3rd day after birth,the level of serum GFAP of children in the mild HIE group was significantly higher than that in the control group (P<0.05).On the 1st,3rd and 7th day after birth,the levels of serum GFAP and UCH-L1 in the moderate HIE group and severe HIE group were significantly higher than those in the control group (P<0.05).The levels of serum UCH-L1 on the 1st,3rd and 7th day after birth and GFAP on the 7th day after birth in the moderate HIE group were significantly higher than those in the mild HIE group,and the levels of serum GFAP and UCH-L1 on the 1st,3rd and 7th day after birth in the severe HIE group were significantly higher than those in the mild HIE group (P<0.05).The levels of serum UCH-L1 on the 1st and 7th day after birth and the level of serum GFAP on the 1st,3rd and 7th day after birth in the severe HIE group were significantly higher than those in the moderate HIE group (P<0.05).The levels of serum GFAP of children on the 1st and 7th day after birth in the moderate HIE group and severe HIE group were significantly higher than those on the 3rd day after birth (P<0.05).Spearman correlation analysis showed that the level of serum GFAP of children on the 1st,3rd and 7th day after birth was positively correlated with the severity of HIE(r=0.740,0.526,0.902;P<0.05),and the level of serum UCH-L1 was also positively correlated with the severity of HIE (r=0.733,0.807,0.799;P<0.05).Conclusion　Within one week after birth,the levels of serum GFAP and UCH-L1 in full-term children with HIE are positively correlated with the severity of the disease.Early detection of serum GFAP and UCH-L1 levels has certain guiding significance for early detection and intervention of HIE.

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更新日期/Last Update: 2022-02-05