脐血NF-kB及MBP检测对早产儿脑白质损伤的早期诊断及其与预后的关系

摘要

Objective:To explore the early change of levels of umbilical cord blood nuclear factor-kB (NF-kB) and myelin basic protein (MBP) in premature infants with white matter damage (WMD) and its relationship with infants' prognosis.Methods:The premature infants who were admitted and diagnosed with WMD were selected and divided into mild group and moderate-severe group according to cranial magnetic resonance imaging (MRI).Another 30 normal premature infants served as control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of NF-kB and MBP in the umbilical cord blood of premature infants.All infants were followed up for 12 months,and Bayley Scales of Infant and Toddler Development was applied to evaluate the psychomotive development index (PDI) and mental development index (MDI) of premature infants with WMD.The changes of the levels of NF-kB and MBP in premature infants with different-degree WMD as well as their correlation with MDI and PDI scores were analyzed.Results:Compared with control group,there were significant differences between mild group and moderate-severe group in the levels of NF-kB and MBP (P<0.05).The levels of NF-kB and MBP increased along with the aggravation of WMD (P<0.05).Moderate-severe group was evidently lower than mild group in MDI and PDI scores (P<0.01).NF-kB level was in negative association with MDI and PDI scores (r=0.736,r=0.648,P<0.05).Moreover,MBP level was also negatively associated with MDI and PDI scores (r=0.625,r=0.842,P<0.05).Conclusion:The levels of NF-kB and MBP increase notably in premature infants with WMD.The severer the WMD is,the higher the levels are.Both NF-kB and MBP are in negative association with MDI and PDI scores,indicating that higher levels of NF-kB and MBP may suggest poor PDI and MDI after infants' delivery.%目的:探讨脑白质损伤(WMD)早产儿脐血核转录因子-kB(NF-kB)与髓磷脂碱性蛋白 (MBP)水平的早期变化及其与预后的关系.方法:选择WMD的早产儿,根据头颅核磁共振成像(MRI)将WMD组早产儿分为轻度组与中重度组.另选取同期30例正常早产儿作为对照组.采用酶联免疫吸附测定法(ELISA)检测所有早产儿脐血NF-kB 和MBP蛋白表达水平.随访12个月后,采用Bayley婴幼儿发育量表对WMD早产儿的运动发育指数(PDI)和智能发育指数(MDI)进行评估.分析其核转录因子-kB(NF-kB) 和MBP在不同严重程度WMD早产儿中的水平变化,及其与MDI和PDI评分的相关性.结论:与对照组比较,WMD组轻度组和中重度组NF-kB和MBP水平差异有统计学意义(P<0.05).随着WMD程度的加重,NF-kB和MBP水平逐渐升高(P<0.05).中重度组WMD早产儿MDI评分和PDI评分均显著低于轻度组(P<0.01).NF-kB水平与MDI评分和PDI评分均呈现负相关(r=0.736,r=0.648,P<0.05).MBP水平与MDI评分和PDI评分均呈负相关(r=0.625,r=0.842,P<0.05).结论:WMD早产儿NF-kB 和MBP水平显著升高,且随着WMD程度的加重,NF-kB和MBP水平越高;与MDI评分和PDI评分呈负相关,提示出生后较高的NF-kB和MBP预示不良的PDI和MDI.