Fiala Małgorzata, Baumert Małgorzata, Surmiak Piotr, Walencka Zofia, Sodowska Patrycja
Klinika Neonatologii Katedry Ginekologii i Położnictwa, Wydział Lekarski w Katowicach, Śląski Uniwerystet Medyczny, Polska.
Ginekol Pol. 2016;87(3):200-4. doi: 10.17772/gp/60552.
The aim of the study was to evaluate activin A and NGAL levels as potential early markers of perinatal hypoxia.
We prospectively studied 58 full-term newborns: 24 with perinatal hypoxia (study group) and 34 healthy controls. Umbilical cord blood samples were obtained from all subjects immediately after delivery for the measurement of activin A and NGAL levels. Both biomarkers were correlated with biochemical indicators od hypoxia and neonatal complications.
Activin A levels were significantly higher in hypoxic as compared to non-hypoxic newborns (0.51 vs. 0.22pg/mL; p<0.01). NGAL levels were also higher in asphyxiated babies as compared to controls (99.1 vs. 22.3ng/mL; p<0.001). A correlation between NGAL and activin A levels was detected (R=0.54; p<0.01). NGAL concentration was also correlated with Apgar score at 5 min. and pH value, HCO3, based deficit and lactate levels. ROC curve analysis demonstrated the cutoff value of >33.9ng/ml for NGAL in prediction of perinatal asphyxia in neonates, with a sensitivity of 100% and specificity 78.3%, whereas the cutoff value for activin A was 0.208ng/ml had, with a sensitivity of 93.1% and only 26.7% specificity.
Asphyxiated neonates demonstrate elevated NGAL and activin A levels as compared to controls. The correlation of NGAL with clinical and biochemical signs of neonatal hypoxia, as well as higher sensitivity and specificity for NGAL measurements, have led us to believe that NGAL could be a better marker of perinatal hypoxia than activin A.
本研究旨在评估激活素A和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平作为围产期缺氧潜在早期标志物的情况。
我们前瞻性地研究了58名足月儿：24名有围产期缺氧的婴儿（研究组）和34名健康对照。所有受试者在分娩后立即采集脐带血样本，以测量激活素A和NGAL水平。两种生物标志物均与缺氧的生化指标及新生儿并发症相关。
与非缺氧新生儿相比，缺氧新生儿的激活素A水平显著更高（0.51对0.22 pg/mL；p<0.01）。与对照组相比，窒息婴儿的NGAL水平也更高（99.1对22.3 ng/mL；p<0.001）。检测到NGAL与激活素A水平之间存在相关性（R=0.54；p<0.01）。NGAL浓度还与5分钟时的阿氏评分以及pH值、碳酸氢根、碱剩余和乳酸水平相关。ROC曲线分析表明，NGAL预测新生儿围产期窒息的临界值>33.9 ng/ml，敏感性为100%，特异性为78.3%，而激活素A的临界值为0.208 ng/ml，敏感性为93.1%，特异性仅为26.7%。
与对照组相比，窒息新生儿的NGAL和激活素A水平升高。NGAL与新生儿缺氧的临床和生化体征之间的相关性，以及NGAL测量具有更高的敏感性和特异性，使我们相信NGAL可能是比激活素A更好的围产期缺氧标志物。
