Jiang Shu-Hong, Wang Jin-Xiu, Zhang Yi-Ming, Jiang Hui-Fen
Changzhou Meternal and Child Care Center, Changzhou, Jiangsu 213003, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2014 Dec;16(12):1193-6.
To evaluate the effect of hypothermia therapy on serum glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) levels in neonates with hypoxic-ischemic encephalopathy (HIE).
Sixty-four HIE neonates were enrolled in this study. Thirty-three neonates with mild HIE were given conventional treatment and 31 neonates with moderate or severe HIE received conventional treatment and hypothermia therapy. Serum levels of GFAP and UCH-L1 were measured using ELISA before treatment and 6-12 hours after treatment.
Serum levels of IL-6, IL-8, GFAP and UCH-L1 in the moderate/severe HIE group were significantly higher than in the mild HIE group (P<0.05) before treatment. Serum GFAP level was positively correlated with serum IL-6 (r=0.54; P<0.05) and IL-8 levels (r=0.63; P<0.05), while negatively correlated with Apgar score (r=-0.47, P<0.05). After treatment, serum levels of IL-6, IL-8 and UCH-L1 in the moderate/severe HIE group were significantly reduced (P<0.05), while serum GFAP levels increased significantly (P<0.05). The patients with abnormal neurological development showed higher serum GFAP levels than those with favourable prognosis (P<0.05). Receiver operating characteristic (ROC) curves analysis demonstrated that the area under curve (AUC) of GFAP and UCH-L1 were 0.714 and 0.703 respectively. At a cut-off value of 0.07 ng/mL, the sensitivity and specificity of GFAP for the diagnosis of HIE were 77% and 78% respectively.
Hypothermia therapy can decrease serum UCH-L1 levels and increase serum GFAP levels in neonates with HIE. Based on their diagnostic value of brain injury, GFAP and UCH-L1 are promising to be novel biomarkers for HIE.
评估亚低温治疗对新生儿缺氧缺血性脑病（HIE）血清胶质纤维酸性蛋白（GFAP）和泛素羧基末端水解酶L1（UCH-L1）水平的影响。
本研究纳入64例HIE新生儿。33例轻度HIE新生儿给予常规治疗，31例中度或重度HIE新生儿接受常规治疗及亚低温治疗。治疗前及治疗后6 - 12小时采用酶联免疫吸附测定法（ELISA）检测血清GFAP和UCH-L1水平。
治疗前，中度/重度HIE组血清白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、GFAP和UCH-L1水平显著高于轻度HIE组（P<0.05）。血清GFAP水平与血清IL-6（r = 0.54；P<0.05）和IL-8水平（r = 0.63；P<0.05）呈正相关，与阿氏评分呈负相关（r = -0.47，P<0.05）。治疗后，中度/重度HIE组血清IL-6、IL-8和UCH-L1水平显著降低（P<0.05），而血清GFAP水平显著升高（P<0.05）。神经发育异常的患者血清GFAP水平高于预后良好的患者（P<0.05）。受试者工作特征（ROC）曲线分析表明，GFAP和UCH-L1的曲线下面积（AUC）分别为0.714和0.703。当临界值为0.07 ng/mL时，GFAP诊断HIE的敏感性和特异性分别为77%和78%。
亚低温治疗可降低HIE新生儿血清UCH-L1水平，升高血清GFAP水平。基于其对脑损伤的诊断价值，GFAP和UCH-L1有望成为HIE的新型生物标志物。
