IL-6、HMGB1、S100B及NSE与新生儿窒息后脑损伤的相关性分析

Study on correlation of interleukin-6, high-mobility group protein B1, astroglial protein, and neuron-specific enolase with neonatal asphyxia brain injury

摘要:

目的 研究白细胞介素-6（IL-6）、高迁移率族蛋白B1（HMGB1）、星形胶质原性蛋白（S100B）及神经元特异性烯醇化酶（NSE）与新生儿窒息（NA）后脑损伤的相关性。方法 回顾性分析2017年2月—2019年2月三亚市人民医院收治的符合入选标准的120例NA患儿的病历资料，按照不同窒息程度分成轻度窒息组92例与重度窒息组28例，另选取同期于该院分娩的足月新生儿100例作为对照组。比较各组血清IL-6、HMGB1、S100B及NSE水平。此外，对120例NA患儿进行头颅CT检查，按照头颅CT检查结果分成头颅CT正常组57例与头颅CT异常组63例，比较两组血清IL-6、HMGB1、S100B及NSE水平，采用Spearman法分析血清IL-6、HMGB1、S100B及NSE水平与NA后脑损伤的相关性。对所有NA患儿均进行为期1年的随访，将其按照随访结果分成预后良好组88例与预后不良组32例，比较两组血清IL-6、HMGB1、S100B及NSE水平。结果 对照组、轻度窒息组、重度窒息组新生儿血清IL-6、HMGB1、S100B及NSE水平整体比较，差异有统计学意义（P <0.05），轻度窒息组、重度窒息组血清IL-6、HMGB1、S100B及NSE水平均高于对照组（P <0.05），且重度窒息组高于轻度窒息组（P <0.05）。NA患儿头颅CT异常组血清IL-6、HMGB1、S100B及NSE水平高于头颅CT正常组（P <0.05）。Spearman相关性分析显示：血清IL-6、HMGB1、S100B、NSE水平与NA后脑损伤均呈正相关（r_s =0.428、0.442、0.385和0.430，均P <0.05）。NA后脑损伤预后不良组血清IL-6、HMGB1、S100B及NSE水平均高于预后良好组（P <0.05）。结论 血清IL-6、HMGB1、S100B及NSE水平与NA程度及NA后脑损伤密切相关，可能作为NA患儿病情评估及预后预测的辅助指标。

Abstract:

Objective To study the correlation of interleukin-6 (IL-6), high-mobility group protein B1 (HMGB1), astrogenic protein (S100B), and neuron-specific enolase (NSE) with neonatal asphyxia (NA) brain injury.Methods From February 2017 to February 2019, 120 children with NA (asphyxia group) who met the inclusion criteria in our hospital were retrospectively selected, and medical records were collected. According to different degrees of asphyxia, 92 cases were classified into mild asphyxia group, and 28 cases were classified into severe asphyxia group. In addition, 100 cases of full-term newborns delivered at the same time in our hospital were recorded as the control group. Serum levels of IL-6, HMGB1, S100B, and NSE were compared in each group. In addition, 120 cases of asphyxiated neonates were examined by head CT. According to the head CT examination results, 57 cases were divided into normal head CT group, and 63 cases were divided into abnormal head CT group. Serum levels of IL-6, HMGB1, S100B, and NSE in the two groups were compared, and the correlation between brain injury and serum levels of IL-6, HMGB1, S100B, and NSE after NA was analyzed by Spearman. All children were followed up for 1 years, and were divided into 88 patients with good prognosis and 32 patients with poor prognosis. Serum levels of IL-6, HMGB1, S100B, and NSE were compared between the two groups.Results The levels of serum IL-6, HMGB1, S100B, and NSE in all group were compared by ANOVA, the differences were statistically significant (P < 0.05); the serum levels of IL-6, HMGB1, S100B, and NSE in mild asphyxia group and severe asphyxia group were higher than those in control group, and the levels of the above indicators in the severe asphyxia group were higher than those in the mild asphyxia group (P < 0.05). The levels of serum IL-6, HMGB1, S100B, and NSE in the abnormal head CT group were higher than those in the normal head CT group (P < 0.05). Spearman correlation analysis showed that brain injury after NA was positively correlated with levels of serum IL-6 (r_s = 0.428), HMGB1 (r_s = 0.442), S100B (r_s = 0.385), and NSE (r_s = 0.430) (P <0.05). The levels of IL-6, HMGB1, S100B, and NSE in the poor prognosis group were higher than those in the good prognosis group (P < 0.05).Conclusion Serum IL-6, HMGB1, S100B, and NSE levels are closely related to the degree of NA and brain injury after asphyxiation, which may be used as an auxiliary index to evaluate the condition and predict the prognosis of NA children.