Abstract

Objective:

Hypoxic-ischemic encephalopathy (HIE) has a high risk of mortality in addition to serious neurological damage. In this study, we investigated the values of umbilical cord netrin-1 (NT-1) and neuron specific enolase (NSE) levels in the early diagnosis of HIE stage II/III induced by neonatal asphyxia.

Study Design:

In the study group, infants with gestational age ≥ 36 weeks who were diagnosed with HIE II/III were included. NT-1 and NSE levels were measured from the umbilical cord immediately after birth. Results were compared between HIE II/III and the healthy control group. Cutoff values for serum NT-1 and NSE were determined with receiver-operating characteristics curves and the area under the curve (AUC) was used to determine the diagnostic value of NT-1 and NSE levels in infants diagnosed with HIE II/III.

Results:

NT-1 (358.3 ± 108.3 pg/mL) and NSE (52.97 ± 17.8 ng/mL) levels in the cord blood in the HIE group were significantly higher (p = .030, p = .001, respectively) than cord blood values in the control group (NT-1 (275.1 ± 84.6 pg/mL) and NSE (28.7 ± 16.3 ng/mL)). NT-1 cutoff value for HIE was 292.3 pg/mL and 34.7 ng/mL for NSE (AUC: 990, sensitivity: 94%, specificity 100% and AUC: 1.0, sensitivity: 100% vs. specificity 100%, respectively).

Conclusion:

NT-1 and NSE represent candidate biomarkers with high reliability in the prediction in newborns with moderate-to-severe HIE.

中文翻译：

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围产期窒息缺氧缺血性脑病患者治疗性低温决策的两个有用的脐带生物标志物：Netrin-1 和神经元特异性烯醇化酶

摘要

客观的：

除了严重的神经损伤外，缺氧缺血性脑病 (HIE) 还具有很高的死亡风险。在这项研究中，我们调查了脐带 netrin-1 (NT-1) 和神经元特异性烯醇化酶 (NSE) 水平在新生儿窒息引起的 HIE II/III 期早期诊断中的价值。

学习规划：

在研究组中，包括被诊断为 HIE II/III 的胎龄≥36 周的婴儿。出生后立即从脐带测量 NT-1 和 NSE 水平。比较 HIE II/III 组和健康对照组的结果。血清 NT-1 和 NSE 的临界值由受试者工作特征曲线确定，曲线下面积 (AUC) 用于确定诊断为 HIE II/III 婴儿的 NT-1 和 NSE 水平的诊断价值。

结果：

HIE 组脐带血中 NT-1 (358.3 ± 108.3 pg/mL) 和 NSE (52.97 ± 17.8 ng/mL) 水平显着高于 脐带血值（分别为p  = .030, p = .001）在对照组 (NT-1 (275.1 ± 84.6 pg/mL) 和 NSE (28.7 ± 16.3 ng/mL))。HIE 的 NT-1 截止值为 292.3 pg/mL 和 NSE 的 34.7 ng/mL（AUC：990，敏感性：94%，特异性 100% 和 AUC：1.0，敏感性：100% 与特异性 100%，分别）。

结论：

NT-1 和 NSE 代表在预测中度至重度 HIE 新生儿中具有高可靠性的候选生物标志物。