新生儿出生时呼吸性酸中毒导致的神经细胞凋亡。

Neuroapoptosis in newborns with respiratory acidosis at birth.

机构信息

Department of Laboratory Medicine, Puerto Real University Hospital, Cadiz, Spain; Department of Biomedicine, Biotechnology and Public Health, Cadiz University School of Medicine, Cadiz, Spain.

Department of Laboratory Medicine, Puerto Real University Hospital, Cadiz, Spain.

出版信息

Clin Biochem. 2019 Dec;74:69-72. doi: 10.1016/j.clinbiochem.2019.08.013. Epub 2019 Aug 29.

DOI:10.1016/j.clinbiochem.2019.08.013

PMID:31473201

Abstract

BACKGROUND

S100B protein is one of the most accurate biomarkers for diagnosis of neuroapoptosis and brain damage. The aim was to evaluate the lactate concentration and acid-base balance (pH, pCO, pO, HCOc and BEb) in umbilical cord blood to predict high risk of neuroapoptosis and analyze the relationship between the levels of these biomarkers and umbilical cord blood S100B protein concentration at birth.

METHODS

Apparently healthy newborns were included. S100B protein and blood gas test (lactate and acid-base balance) were determined in umbilical cord blood at birth. Newborns were classified into two groups: with and without high risk of neuroapoptosis. Newborns with high umbilical cord blood S100B protein concentration were considered newborns at high risk of neuroapoptosis.

RESULTS

Sixty-one newborns were included, 12 had high risk of neuroapoptosis and 49 did not. S100B protein concentration correlate directly with pCO levels (Rho: 0.286, p = .0321) and lactate concentration (Rho: 0.278, p = .0315); and indirectly with pH (Rho: -0.332, p = .01). The analysis of the ROC curves yielded significant curves for pH and pCO to predict high risk of neuroapoptosis, pH optimal cutoff value was 7.19 (sensitivity: 50%, specificity: 83.7%, AUC: 0.708); and pCO optimal cutoff value was 60 mmHg (sensitivity: 30%, specificity: 85.4%, AUC: 0.705).

CONCLUSIONS

Respiratory acidosis is associated to high concentrations of S100B protein in umbilical cord blood at birth. Umbilical cord blood pH and pCO may be useful in differentiating newborns at high risk of neuroapoptosis. Umbilical cord blood gas test may be valuable as risk indicator for neuroapoptosis at birth.

摘要

背景

S100B 蛋白是诊断神经细胞凋亡和脑损伤最准确的生物标志物之一。本研究旨在评估脐血中乳酸浓度和酸碱平衡（pH 值、pCO2、pO2、HCOc 和 BEb）以预测神经细胞凋亡的高危风险，并分析这些生物标志物的水平与出生时脐血 S100B 蛋白浓度之间的关系。

方法

纳入健康的新生儿。在出生时检测脐血 S100B 蛋白和血气分析（乳酸和酸碱平衡）。将新生儿分为两组：有和无神经细胞凋亡高危风险。高脐血 S100B 蛋白浓度的新生儿被认为是神经细胞凋亡高危风险的新生儿。

结果

共纳入 61 例新生儿，其中 12 例有神经细胞凋亡高危风险，49 例无高危风险。S100B 蛋白浓度与 pCO2 水平直接相关（Rho：0.286，p=0.0321）和乳酸浓度（Rho：0.278，p=0.0315）；与 pH 值间接相关（Rho：-0.332，p=0.01）。ROC 曲线分析显示 pH 值和 pCO2 对预测神经细胞凋亡高危风险具有显著曲线，pH 值最佳截断值为 7.19（灵敏度：50%，特异性：83.7%，AUC：0.708）；pCO2 最佳截断值为 60mmHg（灵敏度：30%，特异性：85.4%，AUC：0.705）。