新生儿缺氧缺血性脑病血清高迁移率族蛋白B1 水平及与炎症反应和神经损伤的相关性

Serum high mobility group box-1 protein level in neonatal hypoxic ischemic encephalopathy and its relationship with inflammatory response and nerve injury

摘要:

目的 研究新生儿缺氧缺血性脑病（HIE）血清高迁移率族蛋白B1（HMGB1）水平及其与炎 症因子和神经损伤的关系，探讨HMGB1 在HIE 中的临床意义。方法 选取2008 年1 月—2018 年12 月宁波 市鄞州人民医院和宁波大学医学院附属医院儿科收治的HIE 新生儿120 例作为HIE 组，同期该院健康新生 儿120 例作为对照组。HIE 新生儿根据严重程度分为轻度61 例，中度39 例，重度20 例。测定血清HMGB1、 白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、神经元特异性烯醇化酶（NSE）、S100B 水平。 结果 HIE 组血清HMGB1、IL-6、TNF-α、NSE、S100B 水平高于对照组（P <0.05）。不同严重程度HIE 患儿血清HMGB1、IL-6、TNF-α、NSE、S100B 水平比较，差异有统计学意义（P <0.05），中度和重度HIE 患儿血清HMGB1、IL-6、TNF-α、NSE、S100B 水平高于轻度（P <0.05），重度HIE 患儿血清HMGB1、 IL-6、TNF-α、NSE、S100B 水平高于中度（P <0.05）。HIE 患儿血清HMGB1 与IL-6、TNF-α、NSE、 S100B 呈正相关（r =0.523、0.602、0.497 和0.525，P <0.05）。结论 HIE 新生儿血清HMGB1 水平升高，血 清HMGB1 水平与病情严重程度、炎症因子水平和神经损伤关系密切。

Abstract:

Objective To investigate the serum high mobility group box 1 (HMGB1) level and its relationship with inflammatory factors and nerve damage in neonatal hypoxic ischemic encephalopathy (HIE) in order to explore the clinical significance of HMGB1 in HIE. Methods From January 2008 to December 2018, 120 HIE newborns were selected as HIE group and 120 healthy newborns were selected as controlgroup in the Department of Pediatrics of Ningbo Yinzhou People’s Hospital and Affiliated Hospital of Ningbo University medical school. HIE newborns were classified into mild 61 cases, moderate 39 cases and severe 20 cases accorded to their severity. The serum HMGB1, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), neuron-specific enolase (NSE) and S100B levels were measured. Results The levels of serum HMGB1, IL-6, TNF-α, NSE and S100B in HIE group were higher than those in control group (P < 0.05). The levels of serum HMGB1, IL-6, TNF-α, NSE and S100B in patients with different severity of HIE were statistically significant (P < 0.05), the levels of serum HMGB1, IL-6, TNF-α, NSE and S100B in patients with moderate and severe HIE were higher than those of mild patients(P < 0.05), and the serum HMGB1, IL-6, TNF-α, NSE and S100B levels in patients with severe HIE were higher than those of moderate patients (P < 0.05). The serum HMGB1 in patients with HIE were positively correlated with IL-6 (r = 0.523), TNF-α (r = 0.602), NSE (r = 0.497) and S100B (r = 0.525) (all P < 0.05). Conclusion The serum HMGB1 level is elevated in HIE neonates, and serum HMGB1 level is closely related to severity of disease, inflammat ory factor levels and nerve damage.