缺氧诱导因子1α、Bc1-2/腺病毒E1B19kDa相互作用蛋白3在儿童创伤性脑损伤中的表达及意义OA北大核心CSTPCDMEDLINE
Expression and significance of hypoxia-inducible factor 1a and Bcl-2/adenovirus E1B19kDa-interacting protein 3 in children with traumatic brain injury
目的 动态观察缺氧诱导因子1α(hypoxia-inducible factor 1α,HIF-1α)、Bcl-2/腺病毒E1B19kDa相互作用蛋白 3(Bcl-2/adenovirus E1B19kDa-interacting protein 3,BNIP3)在儿童创伤性脑损伤(traumatic brain injury,TBI)中的变化,并评估其预测儿童TBI病情轻重及预后的临床价值.方法 前瞻性纳入2021年1月—2023年7月47例中重度TBI患儿为研究对象,根据格拉斯哥昏迷评分分为中度亚组(9～12分)和重度亚组(3～8分);以同期因腹股沟斜疝诊治且无基础疾病的30例患儿为对照组.比较各组HIF-1α、BNIP3、自噬相关蛋白Beclin-1及S100B水平的差异,采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评估HIF-1α、BNIP3、Beclin-1及S100B对TBI病情轻重及预后的预测价值.结果 TBI组患儿血清HIF-1α、BNIP3、Beclin-1、S100B水平高于对照组(P＜0.05);TBI患儿中,重度亚组HIF-1α、BNIP3、Beclin-1、S100B水平高于中度亚组(P＜0.05).相关性分析显示,血清HIF-1α、BNIP3、Beclin-1、S100B水平与格拉斯哥昏迷评分呈负相关(P＜0.05).治疗7 d后,非手术TBI和手术TBI患儿的血清HIF-1α、BNIP3、Beclin-1及S100B水平均较治疗前下降(P＜0.05).ROC曲线分析显示,血清HIF-1α、BNIP3、Beclin-1、S100B水平预测重度TBI的曲线下面积分别为0.782、0.835、0.872、0.880(P＜0.05),预测TBI预后不良的曲线下面积分别为0.749、0.775、0.814、0.751(P＜0.05).结论 TBI患儿血清HIF-1α、BNIP3及Beclin-1水平显著升高,检测其水平有助于临床判断TBI患儿的病情轻重及预后.[中国当代儿科杂志,2024,26(4):378-384]
Objective To dynamically observe the changes in hypoxia-inducible factor 1α(HIF-1α)and Bcl-2/adenovirus E1B19kDa-interacting protein 3(BNIP3)in children with traumatic brain injury(TBI)and evaluate their clinical value in predicting the severity and prognosis of pediatric TBI.Methods A prospective study included 47 children with moderate to severe TBI from January 2021 to July 2023,categorized into moderate(scores 9-12)and severe(scores 3-8)subgroups based on the Glasgow Coma Scale.A control group consisted of 30 children diagnosed and treated for inguinal hernia during the same period,with no underlying diseases.The levels of HIF-1α,BNIP3,autophagy-related protein Beclin-1,and S100B were compared among groups.The predictive value of HIF-1α,BNIP3,Beclin-1,and S100B for the severity and prognosis of TBI was assessed using receiver operating characteristic(ROC)curves.Results Serum levels of HIF-1α,BNIP3,Beclin-1,and S100B in the TBI group were higher than those in the control group(P＜0.05).Among the TBI patients,the severe subgroup had higher levels of HIF-1α,BNIP3,Beclin-1,and S100B than the moderate subgroup(P＜0.05).Correlation analysis showed that the serum levels of HIF-lα,BNIP3,Beclin-1,and S100B were negatively correlated with the Glasgow Coma Scale scores(P＜0.05).After 7 days of treatment,serum levels of HIF-1α,BNIP3,Beclin-1,and S100B in both non-surgical and surgical TBI patients decreased compared to before treatment(P＜0.05).ROC curve analysis indicated that the areas under the curve for predicting severe TBI based on serum levels of HIF-1α,BN1P3,Beclin-1,and S100B were 0.782,0.835,0.872,and 0.880,respectively(P＜0.05),and for predicting poor prognosis of TBI were 0.749,0.775,0.814,and 0.751,respectively(P＜0.05).Conclusions Serum levels of HIF-1α,BNIP3,and Beclin-1 are significantly elevated in children with TBI,and their measurement can aid in the clinical assessment of the severity and prognosis of pediatric TBI.IChinese Journal of Contemporary Pediatrics,2024,26(4):378-384]
朱磊;王学成;徐妍妍;王楠;朱炳鑫;李政委
徐州医科大学附属徐州儿童医院重症医学科,江苏徐州 221006徐州医科大学附属徐州儿童医院神经外科,江苏徐州 221006
创伤性脑损伤Bcl-2/腺病毒E1B-19kDa相互作用蛋白3Beclin-1缺氧诱导因子1α儿童
Traumatic brain injuryBcl-2/adenovirus ElB19kDa-interacting protein 3Beclin-1Hypoxia-inducible factor 1αChild
《中国当代儿科杂志》 2024 (004)
378-384 / 7
江苏省卫生健康委科研课题(M2021083);徐州市科技计划项目(KC21152、KC23148);彭城英才-医学青年后备人才项目(XWRCHT20220021).
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