摘要
目的探讨高胆红素血症新生儿血清信号转导和转录激活子3(STAT3)、葡萄糖-6-磷酸脱氢酶(G6PD)表达变化及临床意义。方法选取2021年9月-2022年9月在淮北市妇幼保健院新生儿科住院的高胆红素血症新生儿80例作为观察组,根据新生儿血清总胆红素(TBIL)水平将其分为轻度组(n=24)、中度组(n=41)和重度组(n=15);另以同期在本院新生儿科住院未发生高胆红素血症的新生儿56例作为对照组。收集整理所有新生儿临床基础资料。检测新生儿血清STAT3 mRNA、G6PD和肝功能指标并进行比较分析;分析观察组和对照组临床病理特征间的关系;采用Pearson相关性分析高胆红素血症新生儿血清TBIL水平与STAT3 mRNA、G6PD的相关性;采用多因素logistic回归分析新生儿高胆红素血症发生的影响因素。结果观察组新生儿血清STAT3 mRNA(1.43±0.47)和TBIL水平[(290.62±48.05)μmol/L]显著高于对照组[(1.02±0.29),(118.82±22.83)μmol/L],G6PD活性[(9.72±2.88)U/g]显著低于对照组[(18.56±4.79)U/g],差异均有统计学意义(t=5.797、24.845、13.414,P均<0.05)。中、重度组新生儿血清STAT3 mRNA、TBIL水平显著高于轻度组,G6PD活性显著低于轻度组,差异均有统计学意义(F=9.873、19.263、39.197,P均<0.05);重度组新生儿血清STAT3 mRNA、TBIL水平显著高于中度组,G6PD活性显著低于中度组,差异均有统计学意义(P均<0.05)。观察组新生儿丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和谷氨酰转肽酶(GGT)水平显著高于对照组,差异均有统计学意义(P均<0.05)。Pearson相关性分析显示,观察组新生儿血清TBIL水平与STAT3 mRNA相对表达量成正相关(r=0.358,P<0.05),与G6PD活性成负相关(r=-0.416,P<0.05)。多因素logistic回归分析显示,STAT3 mRNA、G6PD、TBIL、ALT和AST均为新生儿高胆红素血症发生的影响因素(P均<0.05)。结论高胆红素血症新生儿血清STAT3 mRNA水平上调,G6PD活性下调,且两者水平随着病情变化而变化,STAT3 mRNA升高和G6PD活性下降均会增加新生儿高胆红素血症发生的风险。
Objective To investigate the expression changes and clinical significance of serum signal transducer and activator of transcription 3(STAT3)and glucose-6-phosphate dehydrogenase(G6PD)in neonates with hyperbilirubinemia.Methods Atotal of 80 neonates with hyperbilirubinemia hospitalized in the Neonatology Department of Huaibei Maternal and Child Health Hospital from September 2021 to September 2022 were selected as the observation group,according to the serum total bilirubin(TBIL)level of the neonates,were divided into mild group(n=24),moderate group(n=41)and severe group(n=15);and 56 neonates without hyperbilirubinemia hospitalized in the neonatology department of our hospital during the same period were selected as the control group;all the basic clinical data of neonates were collected.The neonatal serum STAT3 mRNA,G6PD and liver function were detected and compared;the relationship between the clinicopathological characteristics of the observation group and the control group was analyzed;Pearson correlation was used to analyze the correlation between serum TBIL level and STAT3 mRNA,G6PD in neonates with hyperbilirubinemia;multivariate logistic regression was used to analyze the influencing factors of neonatal hyperbilirubinemia.Results The levels of serum STAT3 mRNA(1.43±0.47)and TBIL[(290.62±48.05)μmol/L]in the observation group were obviously higher than those in the control group[(1.02±0.29),(118.82±22.83)μmol/L],and the G6PD activity[(9.72±2.88)U/g]was obviously lower than that in the control group[(18.56±4.79)U/g],the differences were statistically significant(t=5.797,24.845,13.414,P all<0.05).The levels of serum STAT3 mRNA and TBIL in the moderate and severe groups were obviously higher than those in the mild group,and the G6PD activity was obviously lower than that in the mild group;the differences were statistically significant(F=9.873,19.263,39.197;P all<0.05);the levels of serum STAT3 mRNA and TBIL in severe group were obviously higher than those in moderate group,while G6PD activity was obviously lower than that in moderate group;the differences were statistically significant(P all<0.05).The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and gamma glutamyl transferase(GGT)in the observation group were obviously higher than those in the control group;the differences were statistically significant(P all<0.05).Pearson correlation analysis shows that,there was a positive correlation between the level of serum TBIL and the relative expression of STAT3 mRNA(r=0.358,P<0.05),and a negative correlation between the level of serum TBIL and G6PD activity(r=-0.416,P<0.05)in the observation group.Multivariate logistic regression analysis showed that,STAT3 mRNA,G6PD,TBIL,ALT and AST were the influencing factors of neonatal hyperbilirubinemia(P all<0.05).Conclusion The level of STAT3 mRNA in serum of neonates with hyperbilirubinemia was up-regulated,and the activity of G6PD was down-regulated;both levels changed with the change of the condition;the increase of STAT3 mRNA and the decrease of G6PD activity could affect the occurrence of neonatal hyperbilirubinemia.
作者
陈文香
随光辉
吴晓龙
CHEN Wenxiang;SUI Guanghui;WU Xiaolong(Department of Neonatology,Huaibei Maternal and Child Health Hospital,Huaibei,Anhui 235000,China;Department of Child Care,Huaibei Maternal and Child Health Hospital,Huaibei,Anhui 235000,China;Department of Laboratory,Huaibei Maternal and Child Health Hospital,Huaibei,Anhui 235000,China)
出处
《热带医学杂志》
CAS
2023年第6期797-802,共6页
Journal of Tropical Medicine
基金
安徽省妇幼健康科研课题(2020FY17)
作者简介
陈文香(1980-),女,本科,副主任医师,从事新生儿科相关疾病研究,E-mail:chenwenxiang49908@163.com
