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目的检测母亲妊娠高血压病(HDCP)新生儿脐血及脐带组织S100B、巨噬细胞炎性蛋白-1α(MIP-1α)的表达,探讨脐血S100B、MIP-1α对母亲HDCP新生儿脑损伤的早期诊断价值。方法将97例HDCP母亲所生新生儿纳入实验组,并根据其出生后7 d或纠正胎龄40周后7 d的20项新生儿神经行为测定(NBNA)评分分为2组:≤35分为脑损伤组(A组),>35分为非脑损伤组(B组);同时选取20例健康母亲所生健康新生儿作为健康对照组(C组)。免疫组织化学法检测其脐带组织S100B、MIP-1α表达;ELISA检测其脐血S100B蛋白、MIP-1α水平。评估脐血S100B、MIP-1α蛋白对母亲HDCP新生儿脑损伤的早期诊断价值。结果1.A、B、C组脐带组织S100B表达差异无统计学意义(P>0.05);A、B组脐血S100B蛋白水平均较C组增高(Pa<0.05)。2.A、B组脐带组织MIP-1α表达差异无统计学意义(P>0.05),但2组脐带组织MIP-1α表达与C组比较差异均有统计学意义(Pa<0.05);A、B组脐血MIP-1α水平均较C组增高(Pa<0.05)。3.A、B组脐血S100B蛋白水平、MIP-1α蛋白水平均与NBNA评分均呈负相关(Pa<0.05);脐血S100B蛋白水平与MIP-1α蛋白水平呈正相关(P<0.05)。4.脐血S100B蛋白ROC曲线下面积为0.992,以95.04 mg.L-1作为S100B的最佳截取值,诊断脑损伤的特异度为94.0%、灵敏度为95.7%;脐血MIP-1α蛋白ROC曲线下面积为0.928,以101.34 pg.L-1作为MIP-1α的最佳截取值时,诊断脑损伤的特异度为82.0%、灵敏度为87.2%。结论脐血S100B蛋白是母亲HDCP新生儿脑损伤早期诊断的可靠指标,且可反映脑损伤程度。MIP-1α对母亲HDCP新生儿脑损伤的早期诊断有一定意义。
Objective To detect the expressions of S100B and MIP-1α in neonatal umbilical cord blood and umbilical cord blood of pregnant women with hypertensive disorder of pregnancy (HDCP), and to investigate the effects of cord blood S100B and MIP-1α on neonatal brain injury in HDCP The early diagnosis value. Methods Ninety-seven newborns born to HDCP mothers were enrolled into the experimental group and were divided into two groups according to their neonatal neurobehavioral assessment (NBNA) score at 7 days after birth or at 7 days after 40 weeks of gestational age correction: ≤35 points (Group A) and> 35 cases were divided into non-brain injury group (group B). At the same time, healthy healthy newborn infants from 20 healthy mothers were selected as healthy control group (group C). The expressions of S100B and MIP-1α in umbilical cord tissue were detected by immunohistochemistry. The levels of S100B protein and MIP-1α in umbilical cord blood were detected by ELISA. To assess the early diagnostic value of umbilical cord blood S100B and MIP-1αprotein in neonatal brain injury in HDCP mothers. There was no significant difference in the expression of S100B in umbilical cord tissues between groups A, B and C (P> 0.05). The levels of S100B protein in cord blood of A and B groups were significantly higher than those in C group (P <0.05). The expression of MIP-1α in umbilical cord tissue of group A and B had no statistical significance (P> 0.05), but the expression of MIP-1α in umbilical cord tissue of group B was significantly different from that in group C (P <0.05) The levels of MIP-1α in group B were higher than those in group C (P <0.05). The levels of S100B protein and MIP-1α protein in cord blood were negatively correlated with NBNA score (P <0.05). The levels of S100B protein in cord blood were positively correlated with MIP-1α protein level (P <0.05). The area under the ROC curve of S100B protein in umbilical cord blood was 0.992. The best cut-off value of S100B was 95.04 mg.L-1, the specificity of diagnosis was 94.0% and the sensitivity was 95.7%. The cord blood MIP-1α protein ROC The area under the curve was 0.928. When the optimal cut-off value of MIP-1α was 101.34 pg.L-1, the specificity of diagnosis of brain injury was 82.0% and the sensitivity was 87.2%. Conclusion Umbilical cord blood S100B protein is a reliable indicator of early diagnosis of neonatal brain injury in HDCP and can reflect the degree of brain injury. MIP-1α is of some significance in the early diagnosis of neonatal brain injury in HDCP mothers.