Roles of serum ACTA，LXA4，Tau protein in prognostic evaluation of children with hypoxic-ischemic encephalopathy

doi:10.3969/j.issn.1673-8640.2022.011.011

Abstract

Abstract:

Objective To investigate the relationship between the expressions of activin A（ACTA），AT-lipoxin A4（LXA4） and Tau protein in children with hypoxic-ischemic encephalopathy（HIE） with neonatal behavioral neurological assessment（NBNA） scores and inflammation，and to analyze the value of each index in predicting the risk of death in children. Methods Totally，145 children with HIE were enrolled and classified into survival group（118 cases） and death group（27 cases） according to the prognosis during hospitalization. The clinical data，serum levels of ACTA，LXA4，Tau protein，interleukin-6（IL-6），tumor necrosis factor-alpha（TNF-α） and high mobility group protein box 1（HMGB1） were compared between the 2 groups. Pearson correlation analysis was used. Logistic regression analysis was used to analyze the correlations of ACTA，LXA4，Tau protein with death. Receiver operating characteristic（ROC）curve was used to evaluate the efficiency of single determinations and combined determination for evaluating the prognosis of HIE. Results In death group，serum ACTA，Tau protein，IL-6，TNF-α，HMGB1 level were higher than those in survival group，and LXA4 was lower than that in survival group（P<0.05）. Serum ACTA and Tau protein were negatively correlated with NBNA scores（P<0.05），they were correlated positively with IL-6，TNF-α and HMGB1（P<0.05），serum LXA4 is positively correlated with NBNA scores（P<0.05），and it was negatively correlated with IL-6，TNF-α and HMGB1（P<0.05）. Serum ACTA，LXA4 and Tau protein were influencing factors for the prognosis of HIE [odds ratios（OR）were 6.133，0.547 and 8.260，95% confidence intervals（CI） were 4.126-9.115，0.347-0.862 and 4.803-14.206]（P<0.05）. The areas under curves（AUC） of serum ACTA，LXA4 and Tau protein single determinations and combined determination in predicting the prognosis of children with HIE were 0.774，0.778，0.840 and 0.871，respectively. Conclusions Serum levels of ACTA，Tau protein and LXA4 in children with HIE were related to NBNA scores and inflammation，and they have certain predictive value for the prognosis of children.

Key words: Activin A, AT-lipoxin A4, Tau protein, Neonatal behavioral neurological assessment, Inflammatory factor, Hypoxic-ischemic encephalopathy

CLC Number:

R446.1

ZHAO Qian, HU Hongxia. Roles of serum ACTA，LXA4，Tau protein in prognostic evaluation of children with hypoxic-ischemic encephalopathy[J]. Laboratory Medicine, 2022, 37(11): 1057-1061.

Figures/Tables 5

References 14

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组别	例数	性别		日龄/d	胎龄/周	出生体质量/kg	分娩方式		体温/℃
组别	例数	男/例	女/例	日龄/d	胎龄/周	出生体质量/kg	自然分娩/例	剖宫产/例	体温/℃
存活组	118	68	50	3.58±0.30	38.26±1.17	3.12±0.34	77	41	37.26±1.23
死亡组	27	15	12	3.52±0.28	37.94±1.22	3.09±0.31	18	9	37.14±1.35
统计值		0.039		0.949	1.272	0.420	0.019		0.449
P值		0.844		0.344	0.205	0.675	0.889		0.654
组别	心率/ （次/min）	病情严重程度			脏器损伤数量		开始治疗日龄		NBNA评分/分
组别	心率/ （次/min）	轻度/例	中度/例	重度/例	<2个/例	≥2个/例	<2 d/例	≥2 d/例	NBNA评分/分
存活组	98.03±7.45	42	50	26	99	19	101	17	28.96±3.16
死亡组	99.27±8.12	2	6	19	14	13	15	12	22.34±2.48
统计值	0.767	4.312			13.120		12.391		10.182
P值	0.444	<0.001			<0.001		<0.001		<0.001

组别	例数	性别		日龄/d	胎龄/周	出生体质量/kg	分娩方式		体温/℃
组别	例数	男/例	女/例	日龄/d	胎龄/周	出生体质量/kg	自然分娩/例	剖宫产/例	体温/℃
存活组	118	68	50	3.58±0.30	38.26±1.17	3.12±0.34	77	41	37.26±1.23
死亡组	27	15	12	3.52±0.28	37.94±1.22	3.09±0.31	18	9	37.14±1.35
统计值		0.039		0.949	1.272	0.420	0.019		0.449
P值		0.844		0.344	0.205	0.675	0.889		0.654
组别	心率/ （次/min）	病情严重程度			脏器损伤数量		开始治疗日龄		NBNA评分/分
组别	心率/ （次/min）	轻度/例	中度/例	重度/例	<2个/例	≥2个/例	<2 d/例	≥2 d/例	NBNA评分/分
存活组	98.03±7.45	42	50	26	99	19	101	17	28.96±3.16
死亡组	99.27±8.12	2	6	19	14	13	15	12	22.34±2.48
统计值	0.767	4.312			13.120		12.391		10.182
P值	0.444	<0.001			<0.001		<0.001		<0.001

组别	例数	ACTA/（ng/L）	LXA4/（μg/L）	Tau蛋白/（ng/L）	IL-6/（ng/L）	TNF-α/（ng/L）	HMGB1/（ng/mL）
死亡组	27	78.73±12.25	0.82±0.11	10.92±1.14	84.17±13.56	180.23±20.41	17.87±3.02
存活组	118	63.29±10.13	0.96±0.13	8.06±1.02	72.05±11.19	162.27±17.58	14.91±2.33
t值		6.862	5.184	12.855	4.874	4.644	5.618
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	ACTA/（ng/L）	LXA4/（μg/L）	Tau蛋白/（ng/L）	IL-6/（ng/L）	TNF-α/（ng/L）	HMGB1/（ng/mL）
死亡组	27	78.73±12.25	0.82±0.11	10.92±1.14	84.17±13.56	180.23±20.41	17.87±3.02
存活组	118	63.29±10.13	0.96±0.13	8.06±1.02	72.05±11.19	162.27±17.58	14.91±2.33
t值		6.862	5.184	12.855	4.874	4.644	5.618
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

项目	β值	标准误	Wald值	P值	OR值（95%CI）
ACTA	1.814	0.525	11.934	<0.001	6.133（4.126~9.115）
LXA4	-0.603	0.201	9.014	<0.001	0.547（0.347~0.862）
Tau蛋白	2.111	0.630	11.233	<0.001	8.260（4.803~14.206）