中度組 > 重度組,差異均有統(tǒng)計學(xué)意義 (P<0.05) ;血清CK-BB、GM-CSF與病情嚴(yán)重程度(賦值:輕度 <sup>=1</sup> 、中度 <sup>=2</sup> 、重度 <sup>=3</sup> )呈正相關(guān),而IGF-1與病情嚴(yán)重程度呈負(fù)相關(guān),差異有統(tǒng)計學(xué)意義( P< 0.05);出生后 24h 內(nèi),預(yù)后良好組血清CK-BB、GM-CSF水平均低于預(yù)后不良組,血清IGF-1水平高于預(yù)后不良組,差異有統(tǒng)計學(xué)意義 (P<0.05) ;以預(yù)后不良患者為陽性樣本,以預(yù)后良好患者為陰性樣本,繪制受試者工作特征(ROC)曲線,結(jié)果顯示,CK-BB、GM-CSF、IGF-1水平單獨及聯(lián)合檢測預(yù)測1個月內(nèi)預(yù)后不良的曲線下面積(AUC)分別為0.786、0.832、0.748、0.916,均具有一定診斷效能,且聯(lián)合檢測診斷效能最高。結(jié)論HIE患兒血清CK-BB、GM-CSF水平升高,IGF-1水平降低,且與病情嚴(yán)重程度密切相關(guān),可作為預(yù)測患兒預(yù)后不良的潛在指標(biāo),且聯(lián)合檢測的預(yù)測價值高于單一檢測。-龍源期刊網(wǎng)" />

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血清肌酸激酶腦型同工酶 胰島素樣生長因子-1 中性粒細(xì)胞-巨噬細(xì)胞集落刺激因子水平 對新生兒缺氧缺血性腦病預(yù)后的預(yù)測價值

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Prognostic value of serum CK-BB,GM-CSF,and IGF-1 levels in predicting the prognosis of neonatal hypoxic-ischemicencephalopathyDuYali,ShiLong.DepartmentofPediatrics,General HospitalofPingmei MedicalGroup,Henan,China

【Abstract】ObjectiveTo analyze thecorrelation between the levels of serum creatine kinase brain-type isoenzyme(CK-BB),insulin-likegrowth factor(IGF)-1,and granulocyte-macrophage colony stimulating factor(GMCSF) and the severity of neonatal hypoxic ischemic encephalopathy (HIE),aswell as their prognosticvalue. MethodsSeventy-five newborn infantswith HIE fromFebruary 2O21 to May 2O23 were selectedas theresearch subjects.The levels of serum CK-BB,GM-CSF,and IGF-1 were comparedamong infants with diferent disease severity,and their correlation with disease severity was analyzed.The newborn infants with HIE were given conventional treatmentand divided intoagood prognosisgroupandapoor prognosisgroup basedon theprognosis of the infants withinone month.The changes in the levels of each serum index were compared,and the predictive value of each serum index for poor prognosis wasanalyzed.ResultsWith the aggavation of the disease degree, serum CK-BB and GM-CSF levels tended to increase,and IGF-1 levels tended to decrease( P <0.05). Serum CKBBand GM-CSF were positively correlated with theseverityof the disease degree,whereas IGF-1 was inversely correlated with it ( P <0.05).Compared with the group with a good prognosis,the group with a poor prognosis had elevated levels of serum CK-BB,GM-CSF,and IGF-1 levels decreased (P<0.05) .The area under the curve (AUC) of the combined detection of serum CK-BB,GM-CSF,and IGF-1 for predicting poor prognosis of children within 1 monthwas higher than that predicted by the indicators alone ( P <0.05).ConclusionThe levels of serum CK-BB and GM-CSF were higher in neonates with HIE,while the levels of IGF-1 was lower,which was closelyrelated to theseverityof the disease.Thecombined detectionof their levelshadacertain predictive valuefor prognosis.

【Keywords】Neonatal;Hypoxic-ischemia,brain;Creatine kinase;Insulin-like growth factorI;Granulocyte -macrophage colony-stimulatingfactor;Forecast

新生兒缺氧缺血性腦病(HIE)是指由圍生期缺氧室息等所致腦部缺血或缺氧性疾病,發(fā)病率在0.1%~0.6% ,嚴(yán)重影響患兒生長發(fā)育,甚至?xí)?dǎo)致患兒死亡。(剩余6320字)

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