目的:本研究检查了全身炎症指标和血红蛋白,白蛋白,淋巴细胞,新生儿缺氧缺血性脑病(HIE)的血小板(HALP)评分。
方法:对43例妊娠36周时中重度HIE患儿进行评估。在出生后0-6小时内开始HT之前以及治疗期间和之后或调整低温之前的60至72小时之间,测量了全身性炎症标志物。
结果:血小板计数,血红蛋白水平,HIE组的血小板指数在两个时间点均显著降低(p=0.001)。低温治疗后,HIE组的中性粒细胞与淋巴细胞比率(NLR)和单核细胞与淋巴细胞比率(MLR)均降低(p=0.001)。癫痫发作,PVL,肾损伤与较高的HALP评分相关。NLR的AUC,PLR,MLR,SII,SIRI,和血小板,中性粒细胞,单核细胞,和淋巴细胞指数(PIV)显示出显着的敏感性和特定的HIE,曲线下面积(AUC)值分别为0.654、0.751、0.766、0.700、0.722和0.749。
结论:低温治疗后,HIE和对照组之间的全身性炎症指标存在显着差异,MLR和NLR显著降低。这些标记,特别是MLR,是包括癫痫在内的不良临床结局的重要预测因子,PVL,和肾脏损伤。
OBJECTIVE: This study examined systemic inflammatory indices and \"Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) scores\" in neonates with hypoxic-ischemic encephalopathy (HIE).
METHODS: A total of 43 neonates with moderate-to-severe HIE at 36 weeks\' gestation were assessed. Systemic inflammatory markers were measured before HT commenced within 0-6 h after birth and between 60 and 72 h during and after therapy or before adjusting for hypothermia.
RESULTS: Platelet counts, hemoglobin levels, and platelet indices in the HIE group were significantly lower at both time points (p = 0.001). Both the neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) decreased in the HIE group after hypothermia therapy (p = 0.001). Seizures, PVL, and kidney injuries were associated with higher HALP scores. The AUCs of NLR, PLR, MLR, SII, SIRI, and platelet, neutrophil, monocyte, and lymphocyte Index (PIV) showed significant sensitivity and specified HIE, with area under the curve (AUC) values of 0.654, 0.751, 0.766, 0.700, 0.722, and 0.749, respectively.
CONCLUSIONS: A significant difference in systemic inflammatory markers was found between the HIE and control groups after hypothermia treatment, with significant reductions in the MLR and NLR. These markers, particularly MLR, were significant predictors of adverse clinical outcomes including seizures, PVL, and kidney damage.