血清CyPA、sCLU、HO-1与新生儿窒息复苏后发生脑损伤的关系研究

摘要 目的：探讨血清亲环素A（CyPA）、丛生蛋白（sCLU）、血红素氧化酶-1（HO-1）与新生儿窒息复苏后发生脑损伤的关系。方法：选择2020年6月至2023年3月湖北民族大学附属民大医院收治的172例窒息新生儿，根据复苏后是否发生脑损伤分为脑损伤组（80例）和无脑损伤组（92例），复苏治疗前检测并对比两组血清CyPA、sCLU、HO-1水平。多因素Logistic回归分析新生儿窒息复苏后发生脑损伤的影响因素，受试者工作特征（ROC）曲线分析血清CyPA、sCLU、HO-1预测新生儿窒息复苏后发生脑损伤的价值。结果：脑损伤组血清CyPA、sCLU、HO-1水平高于无脑损伤组（P＜0.05）。胎盘早剥、母体妊娠高血压疾病、重度窒息、高水平CyPA、高水平sCLU、高水平HO-1是新生儿窒息复苏后发生脑损伤的危险因素（P＜0.05）。血清CyPA、sCLU、HO-1预测新生儿窒息复苏后发生脑损伤的曲线下面积为0.797、0.832、0.779，联合预测的曲线下面积为0.941，高于各指标单独预测。结论：新生儿窒息复苏后发生脑损伤的危险因素包括胎盘早剥、母体妊娠高血压疾病、重度窒息、CyPA升高、sCLU升高、HO-1升高，联合检测血清CyPA、sCLU和HO-1对新生儿窒息复苏后发生脑损伤具有较高的预测价值。

Study on the Relationship between Serum CyPA, sCLU, HO-1 and Brain Injury after Neonatal Asphyxia Resuscitation

ABSTRACT Objective: To investigate the relationship between serum cyclophilin A (CyPA), clusterin (sCLU), heme oxygenase-1 (HO-1) and brain injury after neonatal asphyxia resuscitation. Methods: 172 asphyxiated neonates who were admitted to Minda Hospital Affiliated to Hubei Minzu University from June 2020 to March 2023 were selected, patients were divided into brain injury group (80 cases) and non-brain injury group (92 cases) according to whether brain injury occurred after resuscitation, the levels of serum CyPA, sCLU and HO-1 were detected and compared between two groups before resuscitation. The influencing factors of brain injury after neonatal asphyxia resuscitation were analyzed by multivariate Logistic regression, the value of serum CyPA, sCLU and HO-1 in predicting brain injury after neonatal asphyxia resuscitation were analyzed by receiver operating characteristic (ROC) curve. Results: The levels of serum CyPA, sCLU and HO-1 in brain injury group were higher than those in non-brain injury group (P<0.05). Placental abruption, maternal pregnancy-induced hypertension, severe asphyxia, high level of CyPA, high level of sCLU and high level of HO-1 were risk factors for brain injury after neonatal asphyxia resuscitation (P<0.05). The area under the curve of serum CyPA, sCLU and HO-1 in predicting brain injury after neonatal asphyxia resuscitation was 0.797, 0.832 and 0.779 respectively. The area under the curve of combined prediction was 0.941, which was higher than that of each index alone. Conclusion: The risk factors for brain injury after neonatal asphyxia resuscitation include placental abruption, maternal pregnancy-induced hypertension, severe asphyxia, increased CyPA, increased sCLU, and increased HO-1, combine detection of serum CyPA, sCLU and HO-1 has a high predictive value for brain injury after neonatal asphyxia resuscitation.