摘要
目的探讨热休克蛋白70（HSP70）对新生儿窒息的诊断价值及其与不同窒息程度新生儿NBNA评分的关系。方法选择2014年1月至2016年5月本院产科出生的足月窒息新生儿，根据其窒息程度分为轻度窒息组和重度窒息组；另随机选取Apgar评分正常的足月新生儿为对照组。所有入选新生儿生后立即抽取脐动脉血检测血气，采用酶联免疫吸附（ELISA）法检测各组新生儿脐血中HSP70的表达水平，并在生后第7、14、28天行NBNA评分，比较各组问HSP70表达水平和NBNA评分与窒息的相关性。结果共纳入窒息新生儿81例，其中轻度窒息组46例，重度窒息组35例，对照组共纳入50例。各组新生儿脐血HSP70表达水平差异均有统计学意义（P〈0．05），其中轻、重度窒息组高于对照组[（14．4±2．7）ng／ml、（17．7±4．5）ng／ml比（11．9±2．3）ng／m1]，重度窒息组高于轻度窒息组，差异均有统计学意义（P〈0．05）。各组新生儿生后第7、14、28天NBNA评分及脐血pH差异均有统计学意义（P〈0．05）。相关性分析显示，脐血HSP70表达水平与第7、14、28天NBNA评分及脐血pH均成负相关（r=-0．574、-0．493、-0．208、-0．576，P〈0．05）。HSP70预测新生儿窒息的曲线下面积（AUC）值为0．798（95％C10．722—0．874，P〈0．05）。结论脐血HSP70表达水平与新生儿窒息程度和NBNA评分相关，窒息程度越重，HSP70表达水平越高，NBNA评分越低。
Objective To study the clinical value of heat shock protein （HSP）70 in the diagnosis of neonatal asphyxia and the correlation of HSP70 and Neonatal Behavioral Neurological Assessment （NBNA） score. Methods From January 2014 to June 2016,full-term neonates born in our hospital were enrolled in the study and assigned into mild and severe asphyxia groups. Normally delivered full-term infants were assigned to the control group. Blood from umbilical artery were extracted immediately after birth and HSP70 levels were detected using ELISA. The NBNA scores were recorded at the 7th, 14th and 28th-day after birth. Results HSP70 levels in both mild （n = 46 ）and severe （n = 35 ）asphyxia groups were significantly higher than the control group（ n = 50 ） [ （ 14.4 ± 2.7 ） ng/ml, （ 17.7 ± 4.5 ） ng/ml than （ 11.9 ± 2.3 ）ng/ml ,P 〈0. 05 ]. The severe asphyxia group had even higher HSP70 levels than the mild asphyxia group （ P 〈 0. 05 ）. The NBNA scores of both asphyxia groups were significantly lower than the control group （P 〈 0.05 ）. The umbilical pH values of both two asphyxia groups were also significantly lower than the control group（P 〈0.05 ）. Correlation analysis showed that HSP70 level was negative correlated with NBNA score （ 7th, 14th,28th-day） （ r = - 0. 574, - O. 493, - 0.208, P 〈 0.05 ）. The HSP70 level was negatively correlated with umbilical pH （ r = - 0. 576, P 〈 0.05 ）. The area under curve （ AUC ） for HSP70 levels to predict asphyxia was 0. 798 （95% CI 0. 722 - 0. 874, P 〈 0.05 ）. Conclusions HSP70 level in umbilical cord blood can be used as an indicator for neonatal asphyxia. The more severe the asphyxia, the higher the HSP70 levels and the lower NBNA score and umbilical pH.
出处
《中国新生儿科杂志》
CAS
2017年第1期35-38,共4页
Chinese Journal of Neonatology
作者简介
通信作者：张惠荣，Email：zhr331619@sina．com
