Jiang Feng-Yuan, Liu Hui-Ping, Chen Li-Ting, Song Zhong-Rui, Xu Shang, Guo Yu-Xiu, Zhou Lin, Wang Yu-Kun, Shu Gui-Hua
Department of Pediatrics, Yizheng Hospital, Drum Tower Hospital Group of Nanjing, Yizheng, Jiangsu 211900, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2019 Jun;21(6):573-579. doi: 10.7499/j.issn.1008-8830.2019.06.014.
To study the clinical value of serum neuroglobin in evaluating hypoglycemic brain injury in neonates.
A total of 100 neonates with hypoglycemia were enrolled as subjects. According to amplitude-integrated EEG (aEEG) findings and/or clinical manifestations, they were divided into symptomatic hypoglycemic brain injury group (n=22), asymptomatic hypoglycemic brain injury group (n=37) and hypoglycemic non-brain injury group (n=41). The three groups were compared in terms of blood glucose, duration of hypoglycemia, levels of neuroglobin and neuron-specific enolase (NSE), and modified aEEG score. The correlation of neuroglobin with NSE and modified aEEG score was analyzed. The receiver operating characteristic (ROC) curve was plotted.
Compared with the asymptomatic hypoglycemic brain injury and hypoglycemic non-brain injury groups, the symptomatic hypoglycemic brain injury group had significantly lower blood glucose and modified aEEG score, significantly higher neuroglobin and NSE levels, and a significantly longer duration of hypoglycemia (P<0.05). Compared with the hypoglycemic non-brain injury group, the asymptomatic hypoglycemic brain injury group had significantly lower blood glucose and modified aEEG score, significantly higher neuroglobin and NSE levels, and a significantly longer duration of hypoglycemia (P<0.05). Neuroglobin was positively correlated with NSE and duration of hypoglycemia (r=0.922 and 0.929 respectively; P<0.05) and negatively correlated with blood glucose and modified aEEG score (r=-0.849 and -0.968 respectively; P<0.05). The areas under the ROC curve of neuroglobin, NSE and modified aEEG score were 0.894, 0.890 and 0.941 respectively, and neuroglobin had a sensitivity of 80.8% and a specificity of 95.8% at the optimal cut-off value of 108 mg/L.
Like NSE and modified aEEG score, serum neuroglobin can also be used as a specific indicator for the assessment of brain injury in neonates with hypoglycemia and has a certain value in clinical practice.
探讨血清神经球蛋白在评估新生儿低血糖脑损伤中的临床价值。
选取100例低血糖新生儿作为研究对象。根据振幅整合脑电图(aEEG)结果和/或临床表现,将其分为症状性低血糖脑损伤组(n = 22)、无症状性低血糖脑损伤组(n = 37)和低血糖无脑损伤组(n = 41)。比较三组患儿的血糖、低血糖持续时间、神经球蛋白和神经元特异性烯醇化酶(NSE)水平以及改良aEEG评分。分析神经球蛋白与NSE及改良aEEG评分的相关性。绘制受试者工作特征(ROC)曲线。
与无症状性低血糖脑损伤组和低血糖无脑损伤组相比,症状性低血糖脑损伤组血糖及改良aEEG评分显著降低,神经球蛋白和NSE水平显著升高,低血糖持续时间显著延长(P < 0.05)。与低血糖无脑损伤组相比,无症状性低血糖脑损伤组血糖及改良aEEG评分显著降低,神经球蛋白和NSE水平显著升高,低血糖持续时间显著延长(P < 0.05)。神经球蛋白与NSE及低血糖持续时间呈正相关(r分别为0.922和0.929;P < 0.05),与血糖及改良aEEG评分呈负相关(r分别为 - 0.849和 - 0.968;P < 0.05)。神经球蛋白、NSE及改良aEEG评分的ROC曲线下面积分别为0.894、0.890和0.941,神经球蛋白在最佳截断值为108 mg/L时,灵敏度为80.8%,特异度为95.8%。
血清神经球蛋白与NSE及改良aEEG评分一样,也可作为评估新生儿低血糖脑损伤的特异性指标,在临床实践中有一定价值。