| 刘惠,袁琪,陈娟,等.缺氧缺血性脑病新生儿血清 CXCL12、MASP-3水平与病情、预后的相关性研究[J].安徽医药,2025,29(4):788-792. |
| 缺氧缺血性脑病新生儿血清 CXCL12、MASP-3水平与病情、预后的相关性研究 |
| Correlation of serum CXCL12 and MASP-3 levels with the condition and prognosis of neonates with hypoxic-ischemic encephalopathy |
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| DOI：10.3969/j.issn.1009-6469.2025.04.032 |
| 中文关键词: 缺氧缺血，脑 婴儿，新生 趋化因子 12 甘露糖结合凝集素相关丝氨酸蛋白酶 3 病情程度 预后 |
| 英文关键词: Hypoxia-ischemia,brain Infant,newborn CXC chemokine ligand-12 Mannose binding lectin associated serine pro. |
| 基金项目:安徽省淮北市科技计划立项项目( 2020HK08) |
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| 中文摘要: |
| 目的探讨缺氧缺血性脑病( HIE)新生儿血清趋化因子 12(CXCL12)、甘露糖结合凝集素相关丝氨酸蛋白酶 3(MASP-3)表达情况及与病情、预后的关系，为新生儿 HIE预后评估提供有效依据。方法选取 2021年 2月至 2023年 2月于淮北市人民医院收治的 HIE病人 142例为观察组( n=142)另选取同期于该院分娩的足月健康新生儿为对照组( n=142)根据 HIE疾病严重程度将病儿分为重度组(n=36)、中度组(n=55)，和轻度组( n=51)。根据 HIE预后评价标准将病儿分为预后不，良组( n=41)和预后良好组( n=101)。比较各组血清 CXCL12、MASP-3水平； logistic回归分析 HIE预后不良的影响因素； ROC曲线分析血清 CXCL12、MASP-3对 HIE预后的判断价值。结果观察组血清 CXCL12水平( 25.30±6.31)μg/L均显著高于对照组( 12.62±2.81) μg/L(P<0.05)，MASP-3水平(316.17±76.82)μg/L显著低于对照组( 513.63±116.62)μg/L(P<0.05)；血清 CXCL12水平随着疾病严重程度增加而上升(P<0.05)血清 MASP-3水平随着疾病严重程度增加而下降( P<0.05)；预后不良组阿普加( Apgar)评分、血清 MASP-3水平均显著低于预后良，好组(均 P<0.05)，预后不良组开始治疗日龄、母体贫血发生比例、血清 CXCL12水平均显著高于预后良好组(均 P<0.05)；开始治疗日龄、 CXCL12是 HIE预后不良的独立危险因素(均 P<0.05)MASP-3是保护因素( P<0.05)；血清 CXCL12、MASP-3以及两者联合诊断 HIE预后不良的 AUC分别为 0.82、0.74、0.89，联合的灵敏度为 87.37%，诊断，异度为 75.25%，二者联合优于血清 CXCL12、MASP-3各自单独诊断( Z二者联合 -CXCL12=2.83、Z二者联合 -MASP-3=2.62，均 P<0.05)。结论特HIE新生儿血清 CXCL12水平升高、 MASP-3水平降低，且与 HIE疾病严重程度及预后密切相关，两者联合对判断病儿的预后具有较高的价值。 |
| 英文摘要: |
| Objective To explore the relationship between serum CXC chemokine ligand-12 (CXCL12), mannose-binding lectin-asso. ciated serine protease-3 (MASP-3) and the condition and prognosis of neonates with hypoxic-ischemic encephalopathy (HIE), so as to provide an effective basis for the prognosis evaluation of neonatal HIE.Methods A total of of 142 HIE patients, admitted to HuaibeiPeople's Hospital from February 2021 to February 2023, were collected as the observation group (n=142), and full-term healthy neo. nates delivered in the same hospital during the same period were selected as the control group (n=142). According to the severity of HIE, the children were grouped into severe group (n=36), moderate group (n=55), and mild group (n=51). According to the evaluation criteria for poor prognosis of HIE, the children were grouped into a poor prognosis group (n=41) and a good prognosis group (n=101). The levels of serum CXCL12 and MASP-3 were compared among groups; Logistic regression was applied to analyze the influencing fac.tors for poor prognosis of HIE; receiver operating characteristic (ROC) curve was applied to analyze the value of serum CXCL12 andMASP-3 in prognosis evaluation of HIE.Results Compared with the control group, the observation group had a higher level of serum CXCL12 [(25.30±6.31) μg/L vs. (12.62±2.81) μg/L] (P<0.05), and a lower level of MASP-3 [(316.17±76.82) μg/L vs. (513.63±116.62) μg/L] (P<0.05); the serum CXCL12 level increased with the worsening of the disease (P<0.05), while the serum MASP-3 level de. creased with the worsening of the disease (P<0.05). The Apgar score and serum MASP-3 level in the poor prognosis group were obvious. ly lower than those in the good prognosis group (P<0.05), and the age at the start of treatment, the proportion of maternal anemia, andserum CXCL12 level in the poor prognosis group were obviously higher than those in the good prognosis group (P<0.05); age at the start of treatment and CXCL12 were independent risk factors for poor prognosis of HIE (P<0.05), while MASP-3 was a protective factor (P< 0.05). The areas under the curve (AUC) of serum CXCL12, MASP-3, and their combination in the diagnosis of poor prognosis of HIEwere 0.82, 0.74, and 0.89, respectively. The sensitivity and specificity of the combined diagnosis were 87.37% and 75.25%, respective.ly, indicating that the combined diagnosis was superior to the individual diagnosis of serum CXCL12 or MASP-3(Zcombination-CXCL12=2.83, Zcombination-MASP-3=2.62, all P<0.05).Conclusions The serum CXCL12 level is increased and the serum MASP-3 level is decreased in neo. nates with HIE, which are closely related to the severity and prognosis of HIE. The combination of the two has a high value in judgingthe prognosis of neonates with HIE. |
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