标题：高胆红素血症新生儿S-100、B/A、IGF-1的表达水平及其预测光疗效果的价值

      作者：王倩菲，李萍    西安市人民医院新生儿科，陕西 西安 710000

      卷次： 2023年34卷3期

      【摘要】 目的 检测高胆红素血症新生儿S-100蛋白(S-100)、总胆红素与白蛋白比值(B/A)、胰岛素样生长因子-1 (IGF-1)的表达水平，并探讨其预测光疗效果的价值。方法 选取2019年1月至2021年5月在西安市人民医院新生儿科治疗的97例高胆红素血症新生儿作为观察组，同时选取健康新生儿100例作为对照组，比较两组受检者的S-100、B/A、IGF-1表达水平，同时比较观察组不同病情程度、光疗效果患儿的S-100、B/A、IGF-1表达水平，采用受试者工作特征(ROC)分析S-100、B/A、IGF-1预测光疗效果的价值。结果 观察组患儿的血清S-100和B/A分别为(0.41±0.10) μg/L和0.50±0.13，明显高于对照组的(0.23±0.06) μg/L和 0.19±0.07，而 IGF-1为(30.03±8.41) ng/mL，明显低于对照组的(53.36±11.07) μg/mL，差异均有统计学意义(P<0.05)；观察组中重度组患儿的血清S-100和B/A分别为(0.47±0.10) μg/L和0.62±0.13，明显高于轻中度组患儿的(0.39±0.12) μg/L和0.46±0.11，而IGF-1为(20.55±5.80) ng/mL，明显低于轻中度组患儿的(33.32±6.65) ng/mL，差异均有统计学意义(P<0.05)；观察组中光疗反应敏感患儿的血清IGF-1为(32.28±6.68) ng/mL，明显高于不敏感患儿的(28.45±7.10) ng/mL，差异有统计学意义(P<0.05)；观察组中光疗效果有效患儿的血清S-100和B/A分别为(0.37±0.12) μg/L和0.48±0.11，明显低于无效患儿的(0.60±0.13) μg/L和0.59±0.12，而 IGF-1为(32.24±5.57) ng/mL，明显高于无效患儿的(19.63±4.41) ng/mL，差异均有统计学意义(P<0.05)；IGF-1预测光疗反应敏感的ROC曲线下面积为0.625，灵敏性和特异性分别为68.00%和67.00%；S-100、B/A、IGF-1预测光疗效果有效的ROC曲线下面积分别为0.864、0.733和0.773，灵敏性分别为64.00%、82.00%和68.00%，特异性分别为92.00%、61.00%和78.00%。结论 高胆红素血症新生儿血清S-100和B/A升高，而 IGF-1水平下降，与患儿病情程度、光疗效果有一定相关性，值得进一步研究。
      【关键词】 高胆红素血症；S-100蛋白；总胆红素与白蛋白比值；胰岛素样生长因子-1；新生儿；光疗
      【中图分类号】 R722.19 【文献标识码】 A 【文章编号】 1003—6350（2023）03—0360—05

Significance of expression of S-100, B/A, and IGF-1 in neonates with hyperbilirubinemia and its value inpredicting the effect of phototherapy.
WANG Qian-fei, LI Ping. Department of Neonatology, People's Hospital of Xi'anCity, Xi'an 710000, Shaanxi, CHINA
【Abstract】 Objective To investigate the expression of S-100 protein (S-100), the ratio of total bilirubin to al-bumin (B/A), and insulin-like growth factor-1 (IGF-1) in neonates with hyperbilirubinemia and its value in predictingthe effect of phototherapy. Methods Ninety-seven newborns with hyperbilirubinemia treated in People's Hospital ofXi'an City from January 2019 to May 2021 were selected (observation group). At the same time, 100 healthy newbornswere selected as the control group. The levels of S-100, B/A, and IGF-1 were compared between the two groups, andalso among children with disease severity, different phototherapy effects in the observation group. Receiver operatingcharacteristic (ROC) curve was used to analyze the value of S-100, B/A, IGF-1 to predict the effect of phototherapy.Results The serum S-100 and B/A in the observation group were (0.41±0.10) μg/L and 0.50±0.13, respectively,which were significantly higher than (0.23±0.06) μg/L and 0.19±0.07 in the control group (P<0.05), while IGF-1 was(30.03±8.41) ng/mL, which was significantly lower than (53.36±11.07) ng/mL in the control group (P<0.05). The se-rum S-100 and B/A of severe children in the observation group were (0.47±0.10) μg/L and 0.62±0.13, respectively,which were significantly higher than (0.39±0.12) μg/L and 0.46±0.11 of mild and moderate children (P<0.05), whileIGF-1 was (20.55±5.80) ng/mL, which was significantly lower than (33.32±6.65) ng/mL of mild and moderate chil-dren (P<0.05). The serum IGF-1 of sensitive children in the observation group was (32.28±6.68) ng/mL, which wassignificantly higher than (28.45±7.10) ng/mL in the insensitive children in the observation group (P<0.05). In the ob-servation group, the serum S-100 and B/A of effective children were (0.37±0.12) μg/L and 0.48±0.11, respectively,which were significantly lower than (0.60±0.13) μg/L and 0.59±0.12 of ineffective children (P<0.05), while IGF-1was (32.24±5.57) ng/mL, which was significantly higher than (19.63±4.41) ng/mL of ineffective children (P<0.05).The area under ROC curve of IGF-1 in predicting phototherapy effect sensitivity was 0.625, and the sensitivity andspecificity were 68.00% and 67.00%, respectively. The areas under ROC curve for S-100, B/A, and IGF-1 to predictphototherapy effect were 0.864, 0.733, and 0.773, the sensitivity was 64.00%, 82.00%, and 68.00%, and the specificitywas 92.00%, 61.00%, and 78.00%, respectively. Conclusion Serum S-100 and B/A in neonates with hyperbilirubine-mia increase, while the level of IGF-1 decrease, which are related to the degree of illness and the effect of photothera-py. They are worthy of further study.
      【Key words】 Hyperbilirubinemia; S-100 protein; Ratio of total bilirubin to albumin; Insulin like growth fac-tor-1; Newborn; Phototherapy