中国妇幼健康研究2025，Vol.36Issue(3)：54-59,6.DOI:10.3969/j.issn.1673-5293.2025.03.008
血清神经调节蛋白1、叶酸在超早产儿脑损伤早期诊断、病情及预后评估中的价值研究
Clinical values of serum neuregulin-1 and folic acid for early diagnosis,evaluation of disease condition and prediction of prognosis of brain injury in extremely preterm infants
摘要
Abstract
Objective To investigate clinical values of serum neuregulin-1 and folic acid for early diagnosis,evaluation of disease condition and prediction of prognosis of brain injury in extremely preterm infants.Methods A total of 128 extremely preterm infants who admitted to Qinhuangdao Municipal Maternal and Child Health Hospital,Hebei province from January 2020 to December 2022 were selected as study subjects.60 extremely preterm infants with brain injury were assigned to study group,and 68 healthy extremely preterm infants were divided into control group.Glasgow coma scale(GCs)was applied to evaluate degree of brain injury of extremely preterm infants in the study group,further they were stratified into mild brain injury group(n=23),moderate brain injury group(n=19)and severe brain injury group(n=18).After treatment,these extremely preterm infants in the study group were divided into good prognosis group(n=43)and poor prognosis group(n=17)according to prognoses of the extremely preterm infants.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum level of neuregulin-1,and electrochemiluminescence immunoassay(ECLIA)was applied to detect serum level of folic acid.Spearman correlation analysis was applied to analyze correlation between neuregulin-1 and folic acid,and correlations of the two indexes with severity of brain injury of the extremely preterm infants.Receiver operating characteristic(ROC)curve was applied to analyze diagnostic and predictive values of serum levels of neuregulin-1 and folic acid for early diagnosis and prognosis of the disease.Results The expression levels of serum neuregulin 1 and folic acid in the study group were lower than those in the control group,and the differences were statistically significant(t=6.894 and 8.947 respectively,both P＜0.001).The expression levels of neuregulin 1 and folic acid in serum of the extremely preterm infants in the mild brain injury group,the moderate brain injury group and the severe brain injury group decreased successively,and the differences were statistically significant(F=18.051 and 64.521 respectively,both P＜0.001).Spearman correlation analysis showed that the expression levels of neuregulin 1 and folic acid in serum were both negatively correlated with degree of brain injury(r=-0.624 and-0.539 respectively,both P＜0.05),and neuregulin 1 and folic acid were positively correlated each other(r=0.567,P＜0.05).The expression levels of neuregulin 1 and folic acid in serum of the extremely preterm infants in the good prognosis group were higher than those in the poor prognosis group,and the differences were statistically significant(t=8.685 and 9.419 respectively,both P＜0.001).The areas under the curve(AUCs)of serum neuregulin 1,folic acid and combination of the two indexes for diagnosing brain injury of the extremely preterm infants were 0.864,0.821 and 0.934 respectively,indicating that the diagnostic efficacy of the combination of the two indexes was better(Z=2.869 and 3.603 respectively,both P＜0.05).The AUCs of serum neuregulin 1,folic acid and the combination of the two indexes for predicting poor prognosis of the extremely preterm infants with brain injury were 0.848,0.871 and 0.979 respectively,indicating that the predictive efficacy of the combination of the two indexes was better(Z=2.616 and 2.688 respectively,both P＜0.05).Conclusion The serum levels of neuregulin-1 and folic acid of the extremely preterm infants with brain injury descend,and the two indexes are negatively correlated with degree of brain injury.So,the two indexes have certain diagnostic values for early diagnosis and prediction of poor prognosis of these extremely preterm infants with brain injury.关键词
神经调节蛋白1/叶酸/超早产儿/脑损伤/诊断/预后Key words
neuregulin-1/folic acid/extremely preterm infant/brain injury/diagnosis/prognosis分类
医药卫生引用本文复制引用
姜淑萍,朱洪斌,吴少君,张玲,杨会婵,高彩云,魏雪旭..血清神经调节蛋白1、叶酸在超早产儿脑损伤早期诊断、病情及预后评估中的价值研究[J].中国妇幼健康研究,2025,36(3):54-59,6.基金项目
秦皇岛市科学技术研究与发展项目(202301A262) （202301A262）
