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Value of Phosphorylated tau Protein and Glial Fibrillary Acidic Protein in Early Diagnosis of Neonatal Hypoxic-ischemic encephalopathy Brain Damage |
REN Yan-lin, YU Tian-ying, WANG Lai-er |
Department of Pediatrics, Yulin Hospital of TCM, Yulin Shaanxi, 719000, China |
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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.
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Received: 17 May 2019
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[1] Paneth N. Hypoxia-ischemia and brain injury in infantsborn preterm[J].Dev Med Child Neurol,2018, 60(2):115.
[2] 裴雪梅, 高然, 张国英, 等. 促红细胞生成素对新生儿缺氧缺血性脑病患儿血清 NSE 和 S-100β的影响[J].中国当代儿科杂志, 2014, 16(7):705-708.
[3] 郭志梅, 刘芳, 周春风, 等. 新生儿低血糖脑损伤振幅整合脑电图特征研究[J].临床儿科杂志, 2013, 31(11): 1019-1023.
[4] 刘笑梦, 杨慧敏, 李杏梅. 神经节苷脂钠对新生儿缺氧缺血性脑病血清钙、NO、NSE、S100β 的影响及相关性研究[J].中国妇幼保健, 2014, 29(23):3769-3771.
[5] 穆芳, 刘克宇, 李美荣, 等. 血清IGF-1和hsCRP检测在新生儿缺氧缺血性脑病的诊断价值[J].大家健康(中旬版), 2014, 8(19):173.
[6] 王军, 程萍萍, 袁俊英, 等. 缺氧缺血性脑损伤新生大鼠脑组织神经细胞凋亡情况及 Tau、p-Tau 蛋白表达变化[J].山东医药, 2016, 56(15): 36-38.
[7] 曹玉红, 张光运, 成胜权, 等. 缺氧缺血性脑病新生儿血清胶质纤维酸性蛋白检测及其临床意义[J].中国新生儿科杂志, 2013, 28(2):102-104.
[8] 中华医学会儿科学分会新生儿组. 新生儿缺氧缺血性脑病诊断标准[J].中华儿科学, 2005, 43(8):584.
[9] “九五”攻关项目HIE治疗协作组. 新生儿缺氧缺血性脑病治疗方案(试行稿)[J].中国实用儿科杂志, 2000, 15(6):381-382.
[10] Qiu J, Zhou XY, Zhou XG, et al. Neuroprotective effects of microRNA-210 on hypoxic-ischemic encephyalopathy[J].Biomed Res Int,2013, 2013:350-419.
[11] 钟明, 肖善秋, 朱传瑞, 等. 神经节苷酯辅助亚低温治疗早产儿缺氧缺血性脑病的疗效观察[J].临床医学工程, 2017, 24(2):178-180.
[12] 李海英, 吴尤佳, 孙宝兰, 等. 脐血 S100β、巨噬细胞炎性蛋白-1α对母亲妊娠高血压病所生新生儿脑损伤的早期诊断价值[J].实用儿科临床杂志, 2012, 27(12):925- 927, 933.
[13] 古文熠, 朱培贵, 邹其源, 等. 分析比较 CT 及 MRI 在新生儿缺氧缺血性脑病诊断中价值[J].中华临床医师杂志(电子版), 2016, 10(10):1494-1497.
[14] 马云峰, 王湘庆, 郎森阳, 等. 微管相关蛋白 Tau 蛋白及 Tau 病的研究进展[J].解放军医学院学报, 2015, 36(6):621-624.
[15] 覃川.脑胶质瘤患者血清胶质纤维酸性蛋白浓度及临床价值[J].第三军医大学学报, 2012, 21(34):2214-2215.
[16] 张焕丽. 人类癫痫脑组织的蛋白质组学研究[D]. 济南:山东大学, 2013, 51(3):80-84.
[17] Douglas-Escobar M, Weiss MD. Biomarkers of brain injury in the premature infant[J].Front Neurol,2012,3:185-191. |
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