Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (6): 423-427 DOI: 10.3969/j.issn.2095-5340.2022.06.004 |
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| Expression level of neurofilament light polypeptide in serum of neonates with hypoxicischemic encephalopathy and its relationship with prognosis |
| Ma Yanchun, Wang Hong , Pu Rong
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1. Department of Emergency, Qinghai Province Women and Children's Hospital , Qinghai, Xining 810700, China; 2. Department of Pediatrics, Qinghai Province Women and Children's Hospital, Qinghai, Xining 810700, China
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Abstract 【Abstract】 Objective To observe the expression level of neurofilament light polypeptide (NF-L) in serum of neonatal hypoxic-ischemic encephalopathy (HIE) and its relationship with prognosis. Method A total of 124 children with HIE admitted to Qinghai Province Women and Children's Hospital from March 2018 to March 2019 were included in the study group, according to HIE clinical severity classification, they weredivided into mild (n=41), moderate (n=47) and severe (n=36) ; and 125 healthy neonates born in the same period were included in the control group. Enzyme linked immunosorbent assay (ELISA) was used to detect the level of NF-L in serum, and to compare the level of NF-L between the study group, the control group and different severity HIE; receiver operator characteristic (ROC) curve was used to analyze its predictive value for the poor prognosis of children with HIE. Statistical methods performed by t-test, one-way ANOVA, χ2 test. Result The level of NF-L in the study group was significantly higher than that in the control group [(145.9±30.8) vs (1.3±0.4) ng/L], and the difference was statistically significant (t=52.460, P<0.05). There were no significant differences in gender, gestational age at birth and birth weight among children with different severity of HIE (all P>0.05). The levels of NF-L in serum of mild, moderate and severe children [(116.4±15.7) , (153.2±20.9) and (170.0±28.2) ng/L] were significantly different (F=61.996, P<0.001). Further pairwise comparison showed that the serum level of NF-L in severe and moderate children was higher than that in mild children, and the serum levels of NF-L in severe children were higher than those in moderate children (all P<0.05). The proportion of poor prognosis in children with mild, moderate and severe HIE was compared [0.0% (0/41), 34.0% (16/47) and 61.1% (22/36)], and the difference was statistically significant (χ2=34.093, P<0.001). Further pairwise comparison showed that the proportion of severe and moderate children with poor prognosis was higher than that of mild children, and the proportion of severe children with poor prognosis was higher than that of moderate children (all P<0.05). The level of NF-L in the poor prognosis group was higher than that in the good prognosis group [(169.8±26.7) vs (135.3±20.4) ng/L], and the difference was statistically
significant (t=7.872, P<0.001). ROC curve showed that the area under the curve of serum NF-L level in predicting the adverse prognosis of HIE children was 0.889 (95%CI: 0.827-0.951), and the cut-off value was 140.6 ng/L, its sensitivity was 85.7% and specificity was 79.8%. Conclusion The prognosis of HIE children with different severity is different. NF-L can be used as a serum index to determine the prognosis, which has certain reference value in clinic.
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Received: 28 March 2022
Published: 29 November 2022
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