目的 分析多种实验室指标和炎性因子表达水平与新生儿神经发育的关系,为以后续临床研究提供科学依据。方法 选取医院2020年1月—2021年10月收治的33例孕期发生感染的早产儿作为感染组,同期选取围生期发生窒息的33例早产儿作为窒息组和34例正常早产儿作为对照组。于早产儿出生后1 d时检测凝血功能、全血计数、中性粒细胞、淋巴细胞、炎性因子、神经组织蛋白质S-100β蛋白、神经元特异性烯醇化酶(NSE)、基质金属蛋白酶(MMP)-2、MMP-9等指标,并进行神经发育检查。分析这些指标水平与早产儿神经发育的关系。结果 感染组、窒息组新生儿行为神经(NBNA)评分、发育商均低于对照组,差异有统计学意义(F=53.665,16.468,P＜0.001);感染组、窒息组血清IL-6、肿瘤坏死因子-α(TNF-α)、IL-1β、MMP-2、MMP-9、S-100β蛋白和NSE水平均高于对照组,差异均有统计学意义(F=58.265、38.455、61.490、32.068、67.366、67.666、64.436,P＜0.001);经双变量Pearson相关系数分析检验显示,新生儿NBNA评分(r=-0.594、-0.493、-0.632、-0.304、-0.633、-0.670、-0.569,P＜0.001)、发育商(r=-0.303、-0.291、-0.326、-0.472、-0.310、-0.349、-0.293,P＜0.001)与血清IL-6、TNF-α、IL-1β、MMP-2、MMP-9、S-100β蛋白和NSE水平均呈负相关。结论 多种实验室指标和炎症因子与新生儿神经发育有关,可为早期评估早产儿的神经发育结局和后续治疗提供新思路。
Abstract
Objective To analyze the correlation of various laboratory indicators and the expression level of inflammatory factors with neurodevelopment of newborns, so as to provide scientific basis for further study. Methods From January 2020 to October 2021, a total of 33 premature infants with infection during pregnancy were selected as the infection group. Meanwhile, 33 premature infants with asphyxia during perinatal period were selected as the asphyxia group and 34 normal premature infants as the control group. Blood coagulation function, whole blood count, neutrophils, lymphocytes, inflammatory factors, nerve tissue protein S-100β protein, neuron specific enolase (NSE), matrix metalloproteinase (MMP)-2, MMP-9 and other indicators were detected at the first day after birth of preterm infants, and neurodevelopmental examination was performed. The relationship between the levels of these indicators and the neurodevelopment of premature infants was analyzed. Results Neonatal behavioral neurological assessment (NBNA) score and developmental quotient of children in the infection group and the asphyxia group were significantly lower than those in the control group (F=53.665, 16.468, P<0.001). The levels of serum IL-6, tumor necrosis factor-α (TNF-α), IL-1β, MMP-2, MMP-9, S-100β protein and NSE in the infection group and asphyxia group were significantly higher than those in the control group (F=58.265, 38.455, 61.490, 32.068, 67.366, 67.666, 64.436, P<0.001). The bivariate Pearson correlation coefficient analysis showed that the NBNA score (r=-0.594, -0.493, -0.632, -0.304, -0.633, -0.670, -0.569, P<0.001) and developmental quotient (r=-0.303, -0.291, -0.326, -0.472, -0.310, -0.349, -0.293, P<0.001) were negatively correlated serum levels of IL-6, TNF-α, IL-1β, MMP-2, MMP-9, S-100β protein and NSE. Conclusion Many laboratory indicators and inflammatory factors are related to the neurodevelopment of newborns, which may provide new ideas on early assessment of neurodevelopment and farther treatment for preterm infants.
关键词
早产儿 /
神经发育 /
炎性因子 /
凝血功能 /
基质金属蛋白酶
Key words
premature infants /
neurodevelopment /
inflammatory factors /
coagulation function /
matrix metalloproteinase
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基金
佛山市卫生健康局医学科研课题(20220027)
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