背景:早产儿相关脑损伤是一种常见且严重的并发症,对患病婴儿的生存和发育具有长期影响。目前,某些生物标志物的作用,如蛋白质水解产物SBDP145,褪黑激素,可溶性凝集素样氧化低密度脂蛋白受体-1(sLOX-1),高迁移率族蛋白1(HMGB1),和缺氧诱导因子1-α(HIF-1α)在早产儿相关脑损伤中的作用仍未完全阐明。我们的研究旨在评估SBDP145,褪黑激素,sLOX-1、HMGB1和HIF-1α在早产儿脑损伤中的应用.
方法:选取我院2020年1月至2022年2月收治的135例早产儿,分为早产儿脑损伤组78例,根据磁共振成像结果,另一组57例早产儿无脑损伤或其他疾病。SBDP145,褪黑激素,对两组患者的sLOX-1、HMGB1和HIF-1α进行分析。SBDP145,褪黑激素的血清浓度,观察不同程度脑室出血新生儿sLOX-1、HMGB1和HIF-1α,SBDP145,褪黑激素的水平,比较sLOX-1、HMGB1和HIF-1α在不同程度脑白质损伤患者中的差异。
结果:早产合并脑损伤组SBDP145、sLOX-1、HMGB1和HIF-1α水平明显高于早产组,而褪黑素水平明显低于早产儿组(P<0.05)。新生儿脑室出血中重度组SBDP145、sLOX-1、HMGB1和HIF-1α水平较高,轻度组褪黑素水平较低(P<0.05)。新生儿脑白质损伤中、重度组SBDP145、sLOX-1、HMGB1和HIF-1α水平较高,轻度组褪黑素水平较低(P<0.05)。独立变量是SBDP145,褪黑激素,sLOX-1,HMGB1,HIF-1α,因变量为新生儿脑损伤的预后。进行单因素logistic回归分析和多因素logistic回归分析。结果表明,新生儿脑损伤的影响因素依次为SBDP145、褪黑素、sLOX-1、HMGB1、HIF-1α。
结论:SBDP145,褪黑激素,sLOX-1、HMGB1和HIF-1α在早产儿脑损伤中高表达,当新生儿的病情更严重时,水平会更高。这些研究结果表明,这些生物标志物在预测和监测早产儿脑损伤方面具有潜在的临床应用价值。这可以帮助早期干预并改善长期结果。
BACKGROUND: Prematurity-related brain injury is a common and serious complication that has long-term effects on the survival and development of affected infants. Currently, the roles of certain biomarkers such as the protein hydrolysis product SBDP145, melatonin, soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1), high mobility group box 1 protein (HMGB1), and hypoxia-inducible factor 1-alpha (HIF-1α) in prematurity-related brain injury remain not fully elucidated. Our study aims to assess the significance of SBDP145, melatonin, sLOX-1, HMGB1 and HIF-1α in preterm infants with brain injury.
METHODS: 135 preterm infants admitted to our hospital from January 2020 to February 2022 were selected and divided into 78 cases in a prematurity-associated brain injury group, and 57 cases in another group of preterm infants without brain injury or other diseases according to the magnetic resonance imaging results. The levels of SBDP145, melatonin, sLOX-1, HMGB1 and HIF-1α in the two groups were analyzed. The serum concentrations of SBDP145, melatonin, sLOX-1, HMGB1 and HIF-1α in newborns with different severity of ventricular hemorrhage were observed, and the levels of SBDP145, melatonin, sLOX-1, HMGB1 and HIF-1α in those with different severity of white matter brain injury were compared.
RESULTS: The levels of SBDP145, sLOX-1, HMGB1 and HIF-1α were significantly higher in the preterm combined brain injury group than in the preterm group, and melatonin levels were significantly lower than in the preterm group(P < 0.05). The levels of SBDP145, sLOX-1, HMGB1 and HIF-1α were higher in the moderate to severe group and melatonin levels were lower in the mild group of newborns with ventricular hemorrhage (P < 0.05). The levels of SBDP145, sLOX-1, HMGB1 and HIF-1α were higher in the moderate-severe group and melatonin levels were lower in the mild group in newborns with cerebral white matter injury (P < 0.05). The independent variables were SBDP145, melatonin, sLOX-1, HMGB1, HIF-1α, and the dependent variable was the prognosis of neonates with brain injury. Univariate logistic regression analysis and multivariate logistic regression analysis were performed. The results showed that the influencing factors of newborns with brain injury were SBDP145, melatonin, sLOX-1, HMGB1, HIF-1α.
CONCLUSIONS: The levels of SBDP145, melatonin, sLOX-1, HMGB1 and HIF-1α were highly expressed in preterm newborns with brain injury, and the levels were higher when the condition of the newborns was more severe. These findings suggest the potential clinical utility of these biomarkers in predicting and monitoring brain injury in preterm infants, which could aid in early intervention and improve long-term outcomes.