Abstract:【Objective】To investigate the clinical significance of dynamic monitoring of serum TGF-β1 in children with hypoxic ischemic encephalopathy (HIE). 【Methods】A total of 40 children with HIE admitted to the neonatology department of our hospital from January 2017 to December 30, 2018 were enrolled. According to the HIE clinical classification criteria, they were divided into mild group (19 cases), moderate group (19 cases) and severe group (10 cases). Twenty healthy newborns of hospital delivery during the same period were included in the control group. Levels of peripheral blood transforming growth factor-β1 (TGF-β1) were measured and neonatal neurobehavioral assay (NBNA) were examined in all groups. The diagnostic value of TGF-β1 for moderate to severe HIE was analyzed using ROC curves. 【Results】There were no significant differences in gender, gestational age, mode of delivery, maternal primipara, abortion history, intrauterine infection and premature rupture of membranes in the four groups (P>0.05). There were significant differences in TGF-β1 levels between 24 h and 72 h after birth (P<0.05). However, one week after birth, there was no significant difference in TGF-β1 levels in all groups (P>0.05). The decrease of TGF-β1 level and NBNA score of the HIE children reflected the severity of HIE; the difference was statistically significant (P<0.05). At 24 h, 72 h, and 1 week after birth, TGF-β1 levels were positively correlated with NBNA scores (r=0.523, 0.513, 0.428). At 24 h after birth, the optimal critical point for TGF-β1 diagnosis of moderate-severe HIE was 15.6 μg/L, the sensitivity was 71.5%, the specificity was 79.5%, and the area under the AUC curve was 0.78. 【Conclusion】In the order of mild-moderate-severe HIE, TGF-β1 levels decrease and are positively correlated with NBNA scores.
黄健, 邬吉伟, 罗睿彬, 丘惠娴. 缺氧缺血性脑病患儿血清TGF-β1的变化及其意义[J]. 医学临床研究, 2019, 36(9): 1733-1735.
HUANG Jian, WU Ji-wei, LUO Rui-bin,et al. Changes and Significance of Serum TGF-β1 in Children with Hypoxic Ischemic Encephalopathy. JOURNAL OF CLINICAL RESEARCH, 2019, 36(9): 1733-1735.
[1] Friberg H, Cronberg T. Hypoxic-ischemic encephalopathy[J].Semin Neurol,2017,37(1):3-4. [2] Yildiz EP, Ekici B, Tatli B. Neonatal hypoxic ischemic encephalopathy: an update on disease pathogenesis and treatment[J].Expert Rev Neurother,2017,17(5):449-459. [3] Carreras N, Alsina M, Alarcon A,et al.Efficacy of passive hypothermia and adverse events during transport of asphyxiated newborns according to the severity of hypoxic-ischemic encephalopathy[J].J Pediatr (Rio J),2018,94(3):251-257. [4] 刘雪娇.TGF-β1/Smad2/3通路及Cx43在异氟醚后处理大鼠脑缺血再灌注损伤中的作用[D].新疆:石河子大学,2018. [5] 陈小娜,姜毅.2018昆士兰临床指南:缺氧缺血性脑病介绍[J].中华新生儿科杂志(中英文),2019,34(1):77-78. [6] Robertson IB, Rifkin DB. Regulation of the bioavailability of TGF-beta and TGF-beta-related proteins[J].Cold Spring Harb Perspect Biol,2016,8(6).pii:a021907. [7] 张馨月,李洪鹏.中枢神经损伤后TGF-β1信号通路对神经再生的影响[J].解剖科学进展,2017,23(6):653-655,657. [8] 李小权,张菊平,刘俐, 等.重复应用TGF-β1对缺氧缺血性新生大鼠的影响[J].中国妇幼健康研究,2011,22(3):293-295. [9] Kim BH, Guardia CM, Frondelli M,et al.Age-dependent effects of ALK5 inhibition and mechanism of neuroprotection in neonatal hypoxic-ischemic brain injury[J].Dev Neurosci,2017,39(1-4):338-351. [10] 艾婷,肖谧,林晓洁, 等.血清转化生长因子-β1和脑型肌酸激酶在新生儿缺氧缺血性脑病中的变化及临床意义[J].中国新生儿科杂志,2011,26(1):34-36. [11] Wang H, Chen Z, Li Y,et al.NG25, an inhibitor of transforming growth factor-beta- activated kinase 1, ameliorates neuronal apoptosis in neonatal hypoxic-ischemic rats[J].Mol Med Rep,2018,17(1):1710-1716.