Sestrin2在新生儿缺氧缺血性脑病血清中的表达及与疾病严重程度的关系

李明珠; 温荣华; 岳青

doi:10.16766/j.cnki.issn.1674-4152.003759

Sestrin2在新生儿缺氧缺血性脑病血清中的表达及与疾病严重程度的关系

doi: 10.16766/j.cnki.issn.1674-4152.003759

1.
临汾市人民医院新生儿科，山西临汾 041000
2.
临汾市人民医院医学检验科

基金项目:

山西省卫生健康委员会科研课题 2020142

详细信息

通讯作者:
李明珠，E-mail: lmz1593536@163.com

中图分类号: R722 R446
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- 文章访问数: 14
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- 被引次数: 0
出版历程
- 收稿日期: 2023-12-25
- 网络出版日期: 2024-12-31

Expression of Sestrin2 in serum of neonatal hypoxic-ischemic encephalopathy and its correlation with disease severity

1.
Department of Neonatology, Linfen People's Hospital, Linfen, Shanxi 041000, China

摘要

摘要: 目的探讨新生儿缺氧缺血性脑病(HIE)血清Sestrin2的表达及临床意义，以期提高HIE的诊断准确率，改善预后。方法选取2020年6月—2023年4月临汾市人民医院收治的HIE患儿78例作为HIE组，并根据病情严重程度将其分为轻度HIE组(24例)、中度HIE组(32例)和重度HIE组(22例)。另选取同期在该院出生的正常新生儿30例作为对照组。统计所有新生儿的5 min Apgar评分、新生儿行为神经测定(NBNA)评分，检测血清超氧化物歧化酶(SOD)、丙二醛(MDA)、Sestrin2的水平。结果 HIE组的血清Sestrin2水平高于对照组(P＜0.05)；轻度HIE组、中度HIE组、重度HIE组的血清Sestrin2水平依次升高(P＜0.05)；Pearson相关分析显示，HIE患儿血清Sestrin2水平与血清MDA水平呈正相关关系，与5 min Apgar评分、NBNA评分以及血清SOD水平呈负相关关系(P＜0.05)；ROC曲线分析显示，血清Sestrin2对HIE有一定的辅助诊断价值，曲线下面积为0.818(95% CI：0.732~0.886)，取截断值8.25 ng/mL时，灵敏度为66.67%(52/78)，特异度为93.33%(28/30)，约登指数为0.600。结论 Sestrin2在新生儿HIE血清中呈异常高表达，与患儿病情严重程度和氧化应激程度密切相关，血清Sestrin2检测有助于HIE的辅助诊断。
- 缺氧缺血性脑病 /
- Sestrin2 /
- 氧化应激 /
- 诊断
Abstract: Objective To investigate the expression of serum Sestrin2 in neonates with hypoxic ischemic encephalopathy (HIE) and its clinical significance in order to improve the diagnostic accuracy and prognosis of HIE. Methods A total of 78 HIE children admitted to Linfen People's Hospital from June 2020 to April 2023 were selected as HIE group. They were divided into mild, moderate, and severe HIE subgroups according to the severity of the disease. Additionally, 30 healthy newborns born in our hospital during the same period were selected as the control group. The 5-min Apgar score and neonatal behavioral neurological assessment (NBNA) score of all newborns were recorded. Serum levels of superoxide dismutase (SOD), malondialdehyde (MDA), and Sestrin2 were detected in all newborns. Results The serum levels of Sestrin2 in the HIE group were higher than those in the control group (P < 0.05). Within the HIE group, the levels of serum Sestrin2 increased progressively from mild to severe HIE (P < 0.05). Pearson correlation analysis showed that serum Sestrin2 levels in HIE patients were positively correlated with serum MDA levels and negatively correlated with 5-minute Apgar score, NBNA score, and serum SOD level (P < 0.05). The receiver operating characteristic curve (ROC) analysis showed that serum Sestrin2 had a certain auxiliary diagnostic value for HIE, with an area under the curve of 0.818 (95% CI: 0.732-0.886). At a cut-off value of 8.25 ng/mL, the sensitivity was 66.67% (52/78), the specificity was 93.33% (28/30), and the Youden's J statistic was 0.600. Conclusion The expression of Sestrin2 in the serum of neonates with HIE is abnormally high and closely related to the severity of the disease and the degree of oxidative stress of the neonates. The detection of Sestrin2 in the serum is helpful for the auxiliary diagnosis of HIE.
- Hypoxic ischemic encephalopathy /
- Sestrin2 /
- Oxidative stress /
- Diagnosis

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图 1 血清Sestrin2诊断HIE的ROC曲线

Figure 1. ROC curve of serum Sestrin2 for the diagnosis of HIE

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表 1 对照组和HIE组血清Sestrin2及相关指标比较

Table 1. Comparison of serum Sestrin2 and related indicators between the control group and the HIE group

组别	例数	性别(男/女，例)	胎龄(x±s，月)	分娩方式(阴道分娩/剖宫产，例)	出生体重(x±s，kg)	5 min Apgar评分(x±s，分)	NBNA评分(x±s，分)	SOD(x±s，U/L)	MDA(x±s，nmol/mL)	Sestrin2(x±s，ng/mL)
对照组	30	16/14	39.32±0.92	22/8	3.14±0.63	8.91±0.84	37.89±1.25	98.36±12.33	3.64±1.05	6.87±2.03
HIE组	78	42/36	38.98±0.96	52/26	3.06±0.72	3.62±1.23	32.63±2.42	87.25±11.36	5.42±1.28	10.52±3.13
统计量		0.002^a	1.667^b	0.446^a	0.535^b	21.663^b	11.316^b	4.445^b	6.784^b	5.917^b
P值		0.962	0.098	0.504	0.594	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001
注：^a为χ²值，^b为t值。

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表 2 轻度HIE组、中度HIE组和重度HIE组的血清Sestrin2及相关指标比较

Table 2. Comparison of serum Sestrin2 and related indicators among mild, moderate, and severe HIE group

组别	例数	性别(男/女，例)	胎龄(x±s，月)	分娩方式(阴道分娩/剖宫产，例)	出生体重(x±s，kg)	5 min Apgar评分(x±s，分)	NBNA评分(x±s，分)	SOD(x±s，U/L)	MDA(x±s，nmol/mL)	Sestrin2(x±s，ng/mL)
轻度HIE组	24	14/10	39.04±0.94	17/7	3.08±0.64	4.25±0.52	35.23±2.18	93.11±10.29	4.36±1.12	8.63±2.42
中度HIE组	32	17/15	38.97±0.96	23/9	3.05±0.73	3.68±1.03^c	32.51±2.36^c	87.30±10.79^c	5.58±1.25^c	10.49±3.03^c
重度HIE组	22	11/11	38.93±0.93	12/10	3.05±0.75	2.85±1.01^cd	29.97±2.31^cd	80.78±10.39^cd	6.34±1.29^cd	12.63±3.15^cd
统计量		0.332^a	0.133^b	2.033^a	0.015^b	14.054^b	29.620^b	7.821^b	15.505^b	10.809^b
P值		0.847	0.875	0.362	0.985	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001
注：^a为χ²值，^b为F值；与轻度HIE组比较，^cP＜0.05；与中度HIE组比较，^dP＜0.05。

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表 3 HIE患儿血清Sestrin2与其他指标的相关性

Table 3. Correlation between serum Sestrin2 and other indicators in HIE children

项目	r值	P值
5 min Apgar评分	-0.312	0.009
NBNA评分	-0.363	＜0.001
SOD	-0.486	＜0.001
MDA	0.512	＜0.001

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