Objective To investigate the value of serum long non-coding RNA H19(lncRNA H19)and activin A in the diagnosis and prognosis of neonatal hypoxic-ischemic encephalopathy(HIE).Methods From January 2019 to January 2023,207 children with HIE admitted to the Neonatal Department of Xianyang Central Hospital were selected as the HIE sub-group.According to the severity of the disease,they were divided into 99 cases of mild HIE subgroup,61 cases of moder-ate HIE subgroup and 47 cases of severe HIE subgroup.According to the prognosis at discharge,they were divided into 62 cases of poor prognosis subgroup and 145 cases of good prognosis subgroup.In addition,105 healthy newborns in the same period were selected as the healthy control group.Serum lncRNA H19 level was detected by real-time fluorescence quantitative PCR,and serum Activin A level was detected by enzyme-linked immunosorbent assay.Taking the prognosis of HIE children as the dependent variable,a multivariate unconditional Logistic regression model was established to determine the influencing factors.ROC curve was drawn to evaluate the value of serum lncRNA H19 and Activin A levels in judging the poor prognosis of HIE children.Results Compared with the healthy control group,the serum level of lncRNA H19 in the HIE subgroup was decreased,and the level of Activin A was increased(t/P=34.498/＜0.001,47.114/＜0.001).The levels of serum lncRNA H19 in mild,moderate and severe HIE subgroups decreased in turn,and the levels of Activin A increased in turn(F/P=267.954/＜0.001,349.146/＜0.001).Among the 207 children with HIE,62 cases(29.95％)had poor prognosis.The independent risk factors of poor prognosis in children with HIE were severe HIE and elevated Activin A,the independ-ent protective factors were increased neonatal behavioral neurological assessment score and increased lncRNA H19[OR(95％CI)=6.518(1.824-23292),1.537(1.301-1.814),0.812(0.734-0.898),0502(0387-0.651)];The area under the curve of ser-um lncRNA H19 combined with Activin A level in judging the poor prognosis of HIE children was 0.904,which was greater than 0.783 and 0.790 judged by serum lncRNA H19 and Activin A levels alone(Z/P=4.030/＜0.001,4.048/＜0.001).Conclu-sion The increase of serum lncRNA H19 level and the decrease of Activin A level are related to the aggravation and poor prognosis of HIE children.The value of serum lncRNA H19 combined with Activin A level in judging the prognosis of HIE children is higher.
维普
万方数据
