天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (3): 310-314.doi: 10.11958/20211472

• 临床研究 • 上一篇    下一篇

缺氧缺血性脑病新生儿血清sLOX-1、VILIP-1的变化及临床意义

陈晓玲，陈晓君，杨丽霞，邢舒旺，邱成英   

  1. 1四川大学华西三亚医院新生儿科（邮编572300）,2药剂科
  • 收稿日期:2021-06-21 修回日期:2021-11-03 出版日期:2022-03-15 发布日期:2022-03-15

Changes and clinical significance of serum sLOX-1 and VILIP-1 in neonates with hypoxic ischemic encephalopathy

CHEN Xiaoling, CHEN Xiaojun, YANG Lixia, XING Shuwang, QIU Chengying   

  1. 1 Department of Neonatology, 2 Department of Pharmacy, West China Sanya Hospital, Sichuan University, Sanya 572300, China
  • Received:2021-06-21 Revised:2021-11-03 Published:2022-03-15 Online:2022-03-15

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摘要： 目的　探讨缺氧缺血性脑病（HIE）新生儿血清可溶性凝集素样氧化型低密度脂蛋白受体1（sLOX-1）、视椎蛋白样蛋白1（VILIP-1）的变化及临床意义。方法　HIE患儿（HIE组）146例，分为轻度组（58例）、中度组（52例）和重度组（36例）。另选取正常新生儿50例为对照组。HIE组分别于出生后24 h（T1）、出生后48 h（T2）、出生后72 h（T3）检测血清sLOX-1、VILIP-1水平，对照组于出生后24 h（T1）进行检测。结果　HIE组的5 min Apgar评分、NBNA评分均低于对照组（P＜0.05）；随时间延续，HIE组血清sLOX-1、VILIP-1水平均降低（P＜0.05），与对照组比较，HIE组各时点VILIP-1水平及T1、T2时间点的血清sLOX-1水平均增高（P＜0.05）。随时间延续，轻、中及重度组血清sLOX-1、VILIP-1水平均降低，各时间点轻、中及重度组血清sLOX-1、VILIP-1水平依次升高（P＜0.05）。HIE患儿血清sLOX-1、VILIP-1与5 min Apgar评分、NBNA评分均呈负相关（P＜0.05）；血清sLOX-1（AUC=0.784，95%CI：0.702～0.869）、VILIP-1（AUC=0.752，95%CI：0.655～0.847）对HIE均有较高的诊断价值，两者联合诊断时敏感度［0.863（126/146）］和特异度［0.840（42/50）］均有明显提高。结论　HIE患者血清sLOX-1、VILIP-1表达水平较高，且其病情越严重表达水平越高，动态监测血清sLOX-1、VILIP-1水平对HIE的早期诊断、病情评估具有重要意义。

关键词: 缺氧缺血, 脑, 婴儿, 新生, 疾病, 早期诊断, 可溶性凝集素样氧化型低密度脂蛋白受体1, 视椎蛋白样蛋白1

Abstract: Objective　To investigate the changes and clinical significance of serum soluble lectin like oxidized low density lipoprotein receptor-1 (sLOX-1) and vertebral protein like protein-1 (VILIP-1) in neonates with hypoxic ischemic encephalopathy (HIE). Methods　A total of 146 neonates with HIE were selected as the HIE group. According to the clinical grading standard of HIE, the neonates were divided into the mild group (n=58), the moderate group (n=52) and the severe group (n=36). Another 50 normal neonates were selected as the control group. The serum levels of sLOX-1 and VILIP-1 were detected at 24 h (T1), 48 h (T2) and 72 h (T3) after birth in the HIE group, and the control group was detected at 24 h after birth (T1). Results　The 5 min Apgar score and NBNA score were significantly lower in the HIE group than those in the control group (P＜0.05). Over time, the serum levels of sLOX-1 and VILIP-1 were decreased in the HIE group (P＜0.05). Compared with the control group, the serum levels of VILIP-1 at each time point and the serum levels of sLOX-1 at the T1 and T2 time points were increased in the HIE group (P＜0.05). Over time, the serum levels of sLOX-1 and VILIP-1 were decreased in the mild, moderate and severe groups, and the serum levels of sLOX-1 and VILIP-1 were increased successively at each time point in the mild, moderate and severe groups (P＜0.05). Serum levels of sLOX-1 and VILIP-1 were negatively correlated with 5 min Apgar score and NBNA score in neonates with HIE (P＜0.05). Serum levels of sLOX-1(AUC=0.784, 95%CI: 0.702-0.869) and VILIP-1 (AUC=0.752, 95%CI: 0.655-0.847) showed high diagnostic values for HIE. The sensitivity [0.863 (126/146)] and the specificity [0.840 (42/50)] of the combined detection were significantly improved, and the diagnostic value was further improved. Conclusion　The expression levels of serum sLOX-1 and VILIP-1 increase in HIE, and their expression levels are related to the severity of the disease. Dynamic monitoring of serum levels of sLOX-1 and VILIP-1 is of great significance for the early diagnosis and disease assessment of HIE.

Key words: hypoxia-ischemia, brain, infant, newborn, diseases, early diagnosis, soluble lectin-like oxidized low density lipoprotein receptor 1, vertebrin-like protein 1