| 摘要: |
| ]目的:探讨脂联素(APN)、胰岛素(INS)水平与新生儿缺氧缺血性脑病(NHIE)神经发育结局的关系。 方法:选取 2019 年6 月至 2021 年 5 月我院收治的 123 例 NHIE 患儿,根据患儿神经发育结局[发育商(DQ)]分为神经发育正常组(DQ>75 分)及神经发育异常组(DQ≤75 分),另选取同期于我院出生的健康新生儿 60 例为对照组。 收集患儿一般资料,检测并比较健康儿童与 NHIE 患儿、不同神经发育结局 NHIE 患儿的 APN 和 INS 水平。 采用 Logistic 回归分析 NHIE 神经发育结局的影响因素,采用Pearson 相关性分析 APN、INS 水平与 NHIE 患儿 DQ 的相关性,根据受试者工作特征(ROC)曲线分析 APN、INS 水平对 NHIE 神经发育结局的预测价值。 结果:NHIE 组 APN 水平均低于对照组,INS 水平高于对照组(P<0. 05)。 123 例 NHIE 患儿中,101 例神经发育正常,22 例神经发育异常;神经发育异常组 APN 水平均低于神经发育正常组,INS 水平高于神经发育正常组(P<0. 05)。 经 Logistic 回归分析,APN、INS 低水平是影响 NHIE 神经发育结局的独立危险因素(P<0. 05)。 Pearson 相关性分析显示,NHIE 患儿 APN 水平与 DQ 评分呈正相关(r = 0. 561,P<0. 05),INS 水平与 DQ 评分呈负相关(r = -0. 464,P<0. 05)。 ROC 分析结果显示,APN、INS 及二者联合预测 NHIE 神经发育结局的曲线下面积(AUC)分别为 0. 693、0. 628、0. 835,APN、INS 联合预测效能高于单独检测(P 均<0. 05)。 结论:NHIE 患儿 APN、INS 水平显著降低,APN 水平与 DQ 评分呈正相关,INS 水平与 DQ评分呈负相关,APN 联合 INS 检查对于预测 NHIE 神经发育结局具有较高价值。 |
| 关键词: 新生儿缺氧缺血性脑病 脂联素 胰岛素 神经发育结局 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2024.06.008 |
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| 基金项目:衡水市科技计划项目,编号 2020014035Z |
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| Correlation between Adiponectin, Insulin Levels and Neurodevelopmental Outcomes of Neonates withHypoxic-Ischemic Encephalopathy |
| Yang Bin, Zhao Yuzhuo, Wang Yaqing |
| (The No. 4 People’s Hospital of Hengshui, Hebei Hengshui 053000, China) |
| Abstract: |
| Objective: To explore the correlation between adiponectin (APN), insulin (INS) levels and neurodevelopmental outcomesof neonates with hypoxic-ischemic encephalopathy (NHIE). Methods: A total of 123 children with NHIE admitted into our hospital fromJun. 2019 to May 2021 were extracted. According to the developmental quotient (DQ) of neurodevelopmental outcome, all childrenwere divided into normal neurodevelopmental group (DQ>75 points) and abnormal neurodevelopmental group (DQ≤75 points). Duringthe same period, 60 healthy neonates born in our hospital were enrolled in the control group. General data were collected, APN and INSlevels were detected and compared between healthy children and children with NHIE, and NHIE children with differentneurodevelopmental outcomes. Logistic regression was used to analyze the factors affecting the neurodevelopmental outcomes of NHIE,and Pearson correlation was used to analyze the correlation between APN and INS levels and DQ of children with NHIE. Predictive valueof APN and INS levels to the neurodevelopmental outcomes of NHIE was analyzed according to receiver operating characteristic (ROC)curve. Results: APN levels in NHIE group were lower than those in control group, INS levels were higher than those in control group(P < 0. 05 ). Among the 123 children with NHIE, 101 cases had normal mental development and 22 cases had abnormalneurodevelopment. APN levels in abnormal neurodevelopmental group were lower than those in normal neurodevelopmental group, andINS levels were higher than those in normal neurodevelopmental group (P<0. 05). Logistic regression analysis showed that low levels of APN and INS were independent risk factors affecting the neurodevelopmental outcomes of NHIE ( P < 0. 05). According to Pearsoncorrelation analysis, APN levels of children with NHIE were positively correlated with DQ score (r = 0. 561, P<0. 05), while INS levelswere negatively correlated with DQ score (r = -0. 464, P<0. 05). ROC analysis results showed that the area under the curve (AUC) ofAPN, INS and the combination of APN and INS in predicting the neurodevelopmental outcomes of NHIE were respectively 0. 693, 0. 628and 0. 835, and the combined prediction efficiency of APN and INS was higher than that of single detection (P<0. 05). Conclusion:APN and INS levels are significantly lower in children with NHIE, APN levels are positively correlated with DQ score, INS levels arenegatively correlated with DQ score, and APN combined with INS examination is of high value in predicting neurodevelopmentaloutcomes in NHIE. |
| Key words: neonatal hypoxic-ischemic encephalopathy adiponectin insulin meurodevelopmental outcomes |
