| 黄红梅.血清 UCH-L1、Apelin-13联合头颅超声对新生儿窒息脑损伤的诊断价值[J].安徽医药,2025,29(12):2491-2495. |
| 血清 UCH-L1、Apelin-13联合头颅超声对新生儿窒息脑损伤的诊断价值 |
| Diagnostic value of serum UCH-L1, Apelin-13 combined with cranial ultrasound for traumatic brain injury due to neonatal asphyxia |
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| DOI：10.3969/j.issn.1009-6469.2025.12.034 |
| 中文关键词: 新生儿窒息 缺氧缺血，脑 头颅超声 泛素羧基末端水解酶 活性多肽 13 诊断 |
| 英文关键词: Asphyxia neonatorum Hypoxia-ischemia, brain Cranial ultrasound Ubiquitin carboxy-terminal hydrolase-L1 Apelin-13 Diagnosis |
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| 中文摘要: |
| 目的探究血清泛素羧基末端水解酶( UCH-L1)、活性多肽 13(Apelin-13)联合头颅超声对新生儿窒息脑损伤的诊断价值。方法前瞻性选取 2020年 4月至 2023年 4月在鄂州市妇幼保健院出生的新生儿窒息脑损伤病儿 118例即为研究组，根据阿氏评分( Apgar)分为轻度窒息组 60例，重度窒息组 58例；选择同期在该院生产的健康婴儿 118例为对照组。采用酶联免疫吸附分析( ELISA)测定血清 UCH-L1、Apelin-13的表达水平；受试者操作特征曲线( ROC曲线)分析血清 UCH-L1、Apelin-13对新生儿窒息脑损伤的诊断价值；采用四格表评估头颅超声联合血清 UCH-L1、Apelin-13对新生儿窒息脑损伤的诊断价值。结果与对照组［(3.35±0.40)μg/L、(16.68±2.42)μg/L］相比，研究组病人血清中 UCH-L1(3.81±0.43)μg/L的表达水平显著升高， Apelin-13(14.16±2.56)μg/L的表达水平显著降低( P<0.05)。与轻度窒息组［(3.65±0.43)μg/L、(14.68±2.63)μg/L］相比，重度窒息组病儿血清中 UCH-L1(3.98±0.42)μg/L的表达水平显著升高， Apelin-13(13.62±2.54)μg/L的表达水平显著降低( P<0.05)。轻度窒息组与重度窒息组头颅超声脑水肿检出率［ 61.67%(37/60)比 82.76%(48/58)］比较差异有统计学意义( χ2=6.51，P=0.011)。轻度窒息组与重度窒息组脑室内出血检出率［ 51.67%(31/60)比 86.21%(50/58)］比较差异有统计学意义(χ2=16.35，P<0.001)。与头颅超声正常组［( 2.99±0.42)μg/L、(16.08±2.52)μg/L］相比，头颅超声异常组血清 UCH-L1(4.13±0.43)μg/L表达水平显著升高， Apelin-13(13.42±2.62)μg/L表达水平显著降低( P<0.05)。头颅超声、血清 UCH-L1、Apelin-13三者联合诊断新生儿窒息脑损伤的灵敏度高于单独诊断的灵敏度( P<0.05)。结论新生儿窒息脑损伤病儿血清中 UCH-L1水平升高， Apelin-13水平降低，头颅超声联合血清 UCH-L1、Apelin-13可以提高新生儿窒息脑损伤的诊断效能。 |
| 英文摘要: |
| Objective To explore the diagnostic value of serum ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1), Apelin-13 com-bined with cranial ultrasound for traumatic brain injury due to neonatal asphyxia. Methods A total of 118 neonates with traumatic brain injury asphyxia born in Ezhou Maternal and Child Health Hospital from April 2020 to April 2023 were prospectively selected asthe study group, and they were assigned into the mild asphyxia group (60 cases) and the severe asphyxia group (58 cases) according tothe Apgar score. Meanwhile, 118 healthy infants born in the same period in the hospital were selected as the control group. The expres-sion levels of serum UCH-L1 and Apelin-13 were measured by enzyme-linked immunosorbent assay (ELISA); the diagnostic value of UCH-L1 and Apelin-13 in serum for traumatic brain injury neonatal asphyxia was analyzed by ROC curve; and the diagnostic value ofhead ultrasound combined with serum UCH-L1 and Apelin-13 for traumatic brain injury neonatal asphyxia was evaluated by four-grid table.Results Compared with the control group [(3.35±0.40) μg/L, (16.68±2.42) μg/L], the expression level of UCH-L1 (3.81±0.43) μg/L in the serum of patients in the study group was significantly increased, while the expression level of Apelin-13 (14.16±2.56) μg/L was significantly decreased (P<0.05). Compared with the mild asphyxia group [(3.65±0.43) μg/L, (14.68±2.63) μg/L], the expression level of UCH-L1 (3.98±0.42) μg/L in the serum of children in the severe asphyxia group was significantly increased. The expressionlevel of Apelin-13 (13.62±2.54) μg/L was significantly decreased (P<0.05). There was a statistically significant difference in the detec-tion rate of cerebral edema by cranial ultrasound between the mild asphyxia group and the severe asphyxia group [61.67% (37/60) vs. 82.76% (48/58)] (χ2=6.51, P=0.011). There was a statistically significant difference in the detection rate of intravascular hemorrhagebetween the mild asphyxia group and the severe asphyxia group [51.67% (31/60) vs. 86.21% (50/58)] (χ2=16.35, P<0.001). Compared with the normal head ultrasound group [(2.99±0.42) μg/L, (16.08±2.52) μg/L], the expression level of serum UCH-L1 (4.13±0.43) μg/L in the abnormal head ultrasound group was significantly increased. The expression level of Apelin-13 (13.42±2.62) μg/L was signifi-cantly decreased (P<0.05). The sensitivity of the combined diagnosis of traumatic brain injury due to neontal asphyxia by head ultra-sound, serum UCH-L1 and Apelin-13 was higher than that of the individual diagnosis (P<0.05).Conclusion The serum UCH-L1 level in children with traumatic brain injury due to neonatal asphyxia increases, and the level of Apelin-13 decreases. Head ultrasound com-bined with serum UCH-L1 and Apelin-13 can improve the diagnostic efficacy of traumatic brain injury due to neonatal asphyxia. |
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