2024 年第 4 期 第 19 卷

缺氧缺血性脑病新生儿血清长链非编码RNA H19和神经轴突导向因子1水平变化及临床意义

Changes and clinical significance of serum long chain non-coding RNA H19 and neurite guidance factor-1 levels in newborns with hypoxic ischemic encephalopathy

作者：张冉1袁迅玲2李佳强1

英文作者：Zhang Ran1 Yuan Xunling2 Li Jiaqiang1

单位：1哈尔滨医科大学附属第一医院新生儿科，哈尔滨150010；2黑龙江省医院儿科，哈尔滨150036

英文单位：  1Department of Neonatology the First Affiliated Hospital of Harbin Medical University Harbin 150010 China; 2Department of Pediatrics Heilongjiang Provincial Hospital Harbin 150036 China

关键词：缺氧缺血性脑病；新生儿；长链非编码RNAH19；神经轴突导向因子1

英文关键词：Hypoxicischemicencephalopathy;Newborns;Longchainnon-codingRNAH19;Axonguidancefactor-1

• 摘要：

• 目的 探究缺氧缺血性脑病（HIE）新生儿血清长链非编码RNA H19（lncRNA H19)、神经轴突导向因子1(NT-1)水平及临床意义。方法 选取2019年2月至2021年2月哈尔滨医科大学附属第一医院收治的102例HIE患儿（HIE组）。根据HIE严重程度，分为轻度组（30例）、中度组（41例）和重度组（31例）。根据HIE患儿预后情况，分为预后良好组（76例）和预后不良组（26例）。以同期新生儿外科手术治疗的脐茸、脐尿管瘘患儿作为对照组，共60例。检测新生儿血清lncRNA H19、NT-1水平。采用多因素Logistic回归模型分析影响HIE患儿预后的因素；受试者工作特征（ROC）曲线分析各指标对HIE患儿预后的评估价值。结果 HIE组血清lncRNA H19、NT-1水平均低于对照组［（1.17±0.24）比（2.35±0.53）、（312±71）ng/L比（514±61）ng/L］（均P＜0.001）。轻度组、中度组及重度组血清lncRNA H19、NT-1水平均呈依次降低趋势（均P＜0.05）。多因素Logistic回归分析结果显示，血清lncRNA H19、NT-1是HIE患儿不良预后的危险因素（均P＜0.001）。ROC曲线分析结果显示，lncRNA H19、NT-1联合检测的曲线下面积大于lncRNA H19、NT-1单独检测（Z=4.912，4.763，均P＜0.001）。结论 HIE患儿血清lncRNA H19、NT-1水平降低，与HIE病情程度有关，二者联合对HIE患儿不良预后具有较高的预测价值。

• Objective To investigate the serum levels of long chain non-coding RNA H19 (lncRNA H19) and neurite guidance factor-1 (NT-1) in newborns with hypoxic ischemic encephalopathy (HIE) and their clinical significance. Methods A total of 102 newborns with HIE admitted to the First Affiliated Hospital of Harbin Medical University from February 2019 to February 2021 were selected as HIE group. According to the severity of HIE, they were divided into mild group (30 cases), moderate group (41 cases) and severe group (31 cases). According to the prognosis of HIE newborns, they were divided into the good prognosis group (76 cases) and the poor prognosis group (26 cases). A total of 60 cases of umbilical fistula and urachal fistula treated by neonatal surgery during the same period were selected as the control group. Serum levels of lncRNA H19 and NT-1 were detected. Multivariate Logistic regression model was used to analyze the factors affecting the prognosis of newborns with HIE. The receiver operating characteristic (ROC) curve was used to analyze the value of each index in evaluating the prognosis of newborns with HIE. Results Serum levels of lncRNA H19 and NT-1 in the HIE group were lower than those in the control group ［（1.17±0.24） vs （2.35±0.53）,（312±71）ng/L vs （514±61）ng/L］(both P<0.001). Serum levels of lncRNA H19 and NT-1 in the mild, moderate, and severe groups showed a decreasing trend in sequence (all P<0.05). Multivariate Logistic regression analysis showed that serum lncRNA H19 and NT-1 were risk factors for the poor prognosis in newborns with HIE (both P<0.001). ROC curve analysis showed that the area under the curve of combined detection of lncRNA H19 and NT-1 was larger than that of lncRNA H19 and NT-1 alone (Z=4.912 and 4.763, both P<0.001). Conclusions The levels of serum lncRNA H19 and NT-1 in newborns with HIE are reduced, which is related to the severity of HIE. The combination of the two has a high predictive value for the poor prognosis of children with HIE.