Abstract 【Objective】To investigate the value of phosphorylated tau protein (p-tau) and glial fibrillary acidic protein (GFAP) in the early diagnosis of neonatal hypoxic ischemic encephalopathy (HIE) brain damage. 【Methods】 Sixty-three neonates with hypoxic ischemic encephalopathy who were delivered in our hospital from June 2016 to August 1818 were selected as observation group. According to the severity of hypoxic ischemic encephalopathy, they were divided into the mild group (n=28), the moderate group (n=20) and the severe group (n=15). At the same time, 63 healthy newborns delivered in our hospital were selected as the control group. Levels of p-tau, GFAP, NSE and S100β within 24 hours after delivery were measured and compared between the observation group and the control group. Changes of p-tau, GFAP, NSE and S100β in the mild, moderate, and severe groups before treatment and at 7d, 14d, and 28d after treatment were recorded. Then we analyzed the correlation of p-tau and GFAP with brain injury markers NSE and S100β; ROC curves were used to assess the efficacy of p-tau and GFAP levels in the diagnosis of brain injury. 【Results】 (1) Compared to the control group, the levels of p-tau, GFAP, NSE and S100β in the observation group were significantly higher (P<0.05). (2)The differences of p-tau, GFAP, NSE and S100β among the three groups of different severity were statistically significant (P<0.05). The levels of p-tau, GFAP, NSE and S100β in the severe and moderate groups were higher than those in the mild group (P<0.05). The levels of p-tau, GFAP, NSE and S100β in the moderate group were higher than those in the mild group (P<0.05). (3) With the extension of treatment time, all the indicators in the three groups were improved. After 28 days of treatment, there was no significant difference in p-tau, GFAP, NSE, and S100β between the mild and moderate groups (P>0.05), though there were significant differences between the severe group and the control group (P<0.05). (4) Pearson correlation analysis showed that p-tau was positively correlated with NSE and S100β (P<0.05); and GFAP was positively correlated with NSE and S100β (P<0.05) as well. (5)The area under the curve (AUC) and 95%CI for diagnosing brain injury were 0.764 and (0.457-0.877), respectively. When the cut-off point was 79.47 ng/L, the sensitivity and specificity were 70.7% and 81.2%, respectively. The GFAP level was also used to diagnose the brain damage curve. The area under the area (AUC) and 95%CI for GFAP were 0.646 and (0.568-0.783), respectively. When the cut-off point was 0.71 μg/L, the sensitivity and specificity were 75.8% and 82.8%, respectively. 【Conclusion】The expression of p-tau and GFAP in neonates with hypoxic-ischemic encephalopathy is highly expressed and related to the severity of the disease, which is helpful for diagnosing the degree of brain injury and evaluating the prognosis of the child.
REN Yan-lin,YU Tian-ying,WANG Lai-er. Value of Phosphorylated tau Protein and Glial Fibrillary Acidic Protein in Early Diagnosis of Neonatal Hypoxic-ischemic encephalopathy Brain Damage[J]. JOURNAL OF CLINICAL RESEARCH, 2020, 37(11): 1640-1643.
2020, Vol. 37 
