Neonatal hypoxic-ischemic encephalopathy (HIE) is a disorder mainly due to asphyxia during the perinatal period, and late diagnosis leads to high mortality. In this study, the expression of microRNA-199a (miR-199a) in HIE newborns was investigated, as well as its clinical significance in HIE diagnosis and prognosis. Circulating levels of S100B and NSE in HIE newborns were measured using enzyme-linked immunosorbent assay, and the expression of miR-199a was analyzed using quantitative real-time PCR. The diagnostic value of miR-199a, S100B and NSE was evaluated using the receiver operating characteristic (ROC) analysis, and their prognostic value was assessed by the evaluation of Gesell intellectual development of the HIE newborns. HIE newborns possessed significantly increased levels of S100B and NSE and decreased miR-199a (all P < 0.01). The Neonatal Behavioral Neurological Assessment (NBNA) score of HIE newborns was negatively correlated with S100B and NSE, while was positively correlated miR-199a. The ROC analysis results showed the diagnostic value of serum miR-199a, and the combined detection of miR-199a, S100B and NSE could obtained the highest diagnostic accuracy in HIE newborns. miR-199a expression was lowest in newborns with severe HIE, and it had diagnostic potential to distinguish HIE cases with different severity. Regarding the prognosis of neonatal HIE, the correlation of miR-199a, S100B, NSE with Gesell intellectual development was found in HIE newborns. The decreased miR-199a in HIE newborns serves as a potential diagnostic biomarker and may help to improve the diagnostic and prognostic value of S100B and NSE in neonatal HIE.

译文

新生儿缺氧缺血性脑病 (HIE) 是一种主要由围产期窒息引起的疾病,晚期诊断导致高死亡率。本研究探讨了microRNA-199a (miR-199a) 在HIE新生儿中的表达及其在HIE诊断和预后中的临床意义。采用酶联免疫吸附法测定HIE新生儿循环中S100B和NSE的水平,并采用实时定量PCR分析miR-199a的表达。使用接受者工作特征 (ROC) 分析评估miR-199a,S100B和NSE的诊断价值,并通过评估HIE新生儿的Gesell智力发育评估其预后价值。HIE新生儿S100B和NSE水平明显升高,miR-199a降低 (均p  <  0.01)。HIE新生儿的新生儿行为神经评估 (NBNA) 评分与S100B和NSE呈负相关,miR-199a呈正相关。ROC分析结果显示了血清miR-199a的诊断价值,miR-199a,S100B和NSE联合检测可在HIE新生儿中获得最高的诊断准确性。miR-199a在严重HIE的新生儿中表达最低,并且具有区分不同严重程度的HIE病例的诊断潜力。关于新生儿HIE的预后,发现miR-199a,S100B,NSE与HIE新生儿的Gesell智力发育相关。HIE新生儿miR-199a降低是潜在的诊断生物标志物,可能有助于提高S100B和NSE在新生儿HIE中的诊断和预后价值。

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