血清BNP及γ-GT水平与新生儿窒息神经预后的相关性研究

doi:10.3969/j.issn.1006-6233.2021.06.012

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摘要 目的: 研究血清脑钠肽(BNP)及γ-谷氨酰转肽酶(γ-GT)水平与新生儿窒息神经预后的相关性。方法: 选取2017年2月至2019年6月于本院收治的128例窒息新生儿,其中轻度组76例,重度组52例,另选30例健康新生儿作为对照。比较三组的血清BNP、γ-GT水平,以及不同时间新生儿行为神经评定量表(NBNA)评分,并用ROC曲线分析血清BNP、γ-GT水平对轻度、重度窒息的鉴别效能,用Pearson法分析BNP、γ-GT表达水平与NBNA评分的相关性。结果: 三组新生儿BNP、γ-GT水平比较,差异有统计学意义(P<0.05);其中轻度组、重度组患儿BNP、γ-GT水平均高于对照组(P<0.05);重度组BNP、γ-GT水平均高于轻度组(P<0.05);BNP鉴别轻度、重度窒息的曲线下面积(AUC)为0.885(95%CI:0.827~0.943,P<0.001);γ-GT鉴别轻度、重度窒息的的AUC为0.847(95%CI:0.777~0.917,P<0.001);不同窒息程度及对照组新生儿的NBNA评分比较,差异有统计学意义(P<0.05);不同时间点三组的NBNA评分存在显著差异,NBNA评分逐渐上升,重度组新生儿上升幅度最大(P<0.05);重度组BNP、γ-GT表达水平与第1、7天NBNA评分呈负相关(r=-0.318,r=-0.352,P<0.05)和(r=-0.303,r=-0.380,P<0.05)。结论: 血清BNP、γ-GT有效鉴别新生儿窒息程度,且重度窒息新生儿第1、7天的BNP、γ-GT表达水平与神经预后存在相关性,窒息程度愈严重,BNP、γ-GT表达水平越高,NBNA评分越低。

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	张薇
	羊玲
	钟丽花

关键词 ：脑钠肽, γ-谷氨酰转肽酶, 新生儿窒息, 神经预后

Abstract：Objective: To study the correlation between serum brain natriuretic peptide (BNP), γ-glutamyl transpeptidase (γ-GT) levels and neural prognosis in asphyxia neonates. Methods: A total of 128 asphyxia neonates who were admitted to the hospital from February 2017 to June 2019 were enrolled, including 76 cases in mild group and 52 cases in severe group. Another 30 healthy neonates were enrolled as control group. The levels of serum BNP and γ-GT, and scores of neonatal behavioral neurological assessment (NBNA) were compared among the three groups. The efficiency of serum BNP and γ-GT levels for distinguishing mild asphyxia from severe asphyxia was analyzed by ROC curves. The correlation between expression level of BNP and γ-GT and NBNA score was analyzed by Pearson method. Results: There were significant differences in levels of BNP and γ-GT among the three groups (P<0.05). The levels of BNP and γ-GT were the highest in severe group, followed by mild groups and control group (P<0.05). The area under the curve (AUC) values for BNP and γ-GT to identify mild and severe asphyxia were 0.885 (95%CI: 0.827-0.943, P<0.001) and 0.847 (95%CI: 0.777-0.917, P<0.001), respectively. There were significant differences in NBNA scores of newborns with different degrees of asphyxia compared with control group (P<0.05).There were significant differences in NBNA scores among the three groups at different times, and the NBNA scores gradually increased, whose increase was more significant in severe group (P<0.05). The expression levels of BNP and γ-GT were negatively correlated with NBNA scores on the first day and 7th day in severe group [(r=-0.318, r=-0.352, P<0.05), (r=-0.303, r=-0.380, P<0.05)]. Conclusion: Serum BNP and γ-GT can effectively distinguish the severity of neonatal asphyxia. The expression levels of BNP and γ-GT on the first day and 7th day are correlated with neural prognosis in severe asphyxia neonates. The more severe the asphyxia, the higher the expression levels of BNP and γ-GT, and the lower the NBNA score.

Key words： Brain natriuretic peptide γ-glutamyl transpeptidase Neonatal asphyxia Neural prognosis

基金资助:海南省卫生计生行业科研项目,(编号:15A200096)

引用本文:

张薇, 羊玲, 钟丽花. 血清BNP及γ-GT水平与新生儿窒息神经预后的相关性研究[J]. 河北医学, 2021, 27(6): 935-938.
ZHANG Wei, YANG Ling, ZHONG Lihua. Research on the Correlation Between Serum BNP γ-GT Levels and Neural Prognosis in Asphyxia Neonates. HeBei Med, 2021, 27(6): 935-938.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.06.012 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I6/935

[1] 陈自励,刘敬,封志纯.新生儿窒息诊断和分度标准建议[J].中国当代儿科杂志,2013,15(1):1.
[2] Gagnon MH,Winterark P.Effect of persistent pulmonary hypertension on brain oxygenation in asphyxiated term newborns treated with hypothermia[J].Matern Fetal Neonatal Med,2016,29(13):2049~2055.
[3] Sweetan DU,Onwuneme C,Watson WR,et al.Perinatal asphyxia and erythropoietin and VEGF:serial serum and cerebrospinal fluid responses[J].Neonatology,2017,111(3):253~259.
[4] 连喜院,李宏科,靳彩虹,等.B型脑钠肽与N端脑钠肽前体在新生儿窒息后心力衰竭辅助诊断中的比较[J].中国小儿急救医学,2016,23(9):616~620.
[5] Committee on Obstetric Practice,ACOG,American Academy of Pediatrics,et al.ACOG committee opinion.number 333,May 2006 (replaces No.174,July 1996):The apgar score.[J].Obstet Gynecol,2006,107(5):1209~1212.
[6] 中华医学会围产医学会新生儿复苏组.新生儿窒息诊断的专家共识[J].中华围产医学杂志,2016,19(1):3~6.
[7] 鲍秀兰.新生儿行为和0-3岁教育[M].北京:中国少年儿童出版社,1995.120.
[8] Psotka MA,Schiller NB,Whooley MA,et al.Association of change in 5-year N-terminal fragment of the prohormone brain-type natriuretic peptide with left ventricular structure and function in stable coronary disease[J].Cardiovasc Med,2018,19(2):67~72.
[9] 李硕,黎百志,李晓慧,等.血清红细胞分布宽度尿酸和脑钠肽联合检测在诊断慢性心力衰竭中的临床价值[J].河北医学,2019,25(5):841~844.
[10] Rouatbi H,Zigabe S,Gkiougki E,et al.Biomarkers of neonatal stress assessment:a prospective study[J].Early Hum Dev,2019,137:104826.
[11] Sulava E,Bergin S,Long B,et al.Elevated liver enzymes:emergency department-focused management[J].Emerg Med,2017,52(5):654~667.
[12] 黄晓玲,陈柏梁,仇烨,等.血清肌钙蛋白Ⅰ,血浆脑钠肽联合心脏Tei指数评估窒息新生儿心肌损伤及心功能[J].中华实用儿科临床杂志,2014,29(14):1112~1114.
[13] 庄根苗,唐玲,臧丽娇,等.新生儿缺氧缺血性脑病中血清前白蛋白水平与新生儿行为神经测定的相关性[J].山东大学学报(医学版),2016,54(12):37~40.
[14] 王幽梦,鲁利群,屈艺.VEGF、HSP 70和NBNA评分与新生儿窒息的相关性[J].实用医学杂志,2018,34(9):155~158.