Association of serum granulocyte-macrophage colony-stimulating factor with disease severity and prognosis in neonates with hypoxic-ischemic encephalopathy
Chen Liqi , Li Wen, Fu Xiuhua, et al
(1. Department of Pediatrics, Chengde Central Hospital, Hebei, Chengde 067000, China; 2. The Outpatient Department, Chengde Municipal Government, Hebei, Chengde 067000, China)
Abstract: 【Abstract】 Objective To investigate the relationship between granulocyte-macrophage colony-stimulating factor (GM-CSF) and the severity and prognosis in neonates with hypoxic-ischemic encephalopathy (HIE). Method The clinical data of 109 neonates with HIE admitted to Chengde Central Hospital from July 2019 to October 2021 were retrospectively analyzed. Based on the prognosis within, the cases were divided into the survival group (n=90) and the death group (n=19). The GM-CSF levels, Apgar scores, and Neonatal Behavioral Neurological Assessment (NBNA) scores were compared between the two groups of children. Meanwhile, the GM-CSF levels were compared among patients with different Apgar score ranges and different NBNA score ranges. The Spearman method was used to analyze the correlation between serum GM-CSF and Apgar scores as well as NBNA scores. Multivariate Logistic regression analysis was applied to evaluate the risk factors for death in children with hypoxic-ischemic encephalopathy (HIE). The area under the receiver operating characteristic curve (AUC) was used to assess the prognostic value of serum GM-CSF in neonates with HIE. The statistical methods employed included the t-test and χ2 test.Result The GM-CSF level in the death group was higher than that in the survival group [(175.38±27.44) mg/L vs (149.85±27.19) mg/L, t=3.713, P<0.001]. The Apgar scores and NBNA scores in the death group were lower than those in the survival group [(3.16±0.98) points, (29.63±6.88) points vs (6.95±1.47) points, (34.80±5.09) points, t values were 10.725 and 3.769, respectively, all P<0.001]. With the decrease of Apgar scores and NBNA scores, serum GM-CSF levels were gradually increased (P<0.001), and there were significant differences in the GM-CSF levels among neonates with different Apgar and NBNA score intervals (all P<0.001). The results of Spearman correlation analysis showed that serum GM-CSF levels were negatively correlated with Apgar and NBNA scores (r values were -0.597, -0.647, respectively, all P<0.05). Multivariate Logistic regression analysis showed that high GM-CSF level and low Apgar score were independent risk factors for death within 28 d of neonates with HIE (all P<0.05). The cut-off value of serum GM-CSF level predicting death within 28 d of neonates with HIE was 173.86 mg/L, and the AUC was 0.859. Conclusion The serum GM-CSF level of neonates with HIE is correlated with NBNA and Apgar scores, which can be used to evaluate the severity and prognosis of neonates with HIE.
陈丽祺 李文 付秀华 付喜英 肖志欣 李利华 闫永垒. 缺氧缺血性脑病患儿血清粒细胞 - 巨噬细胞集落刺激因子与病情严重程度以及预后的关系[J]. 发育医学电子杂志, 2025, 13(5): 366-371.
Chen Liqi , Li Wen, Fu Xiuhua, et al. Association of serum granulocyte-macrophage colony-stimulating factor with disease severity and prognosis in neonates with hypoxic-ischemic encephalopathy. Journal of Developmental Medicine(Electronic Version), 2025, 13(5): 366-371.
2025, Vol. 13 
