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目的:检测妊娠期高血压疾病新生儿脐带组织核转录因子κB(NF-κB)、S100B的表达及脐血S100B水平,探讨NF-κB、S100B在妊娠期高血压疾病新生儿脑损伤中的早期诊断价值。方法:选择97例妊娠期高血压疾病新生儿,根据生后第3～7天或纠正胎龄40周后3～7天的20项新生儿神经行为测定(NBNA)评分分为两组:≤35分为脑损伤组,>35分为非脑损伤组;同时选取20例健康新生儿作为对照组。免疫组织化学法检测κB、S100B表达;酶联免疫吸附法(ELISA)检测脐血S100B蛋白。结果:NF-κB在脐带组织存在表达,脑损伤组与非脑损伤组脐带组织NF-κB表达无统计学差异(P>0.05),但两组脐带组织NF-κB表达与正常对照组间均有统计学差异(P<0.05)。S100B在脐带组织存在表达,脑损伤组、非脑损伤组及正常对照组间脐带组织S100B表达无统计学差异(P>0.05);脑损伤组脐血S100B蛋白水平较非脑损伤组显著增高,非脑损伤组脐血S100B蛋白水平也较正常对照组显著增高(P<0.05)。孕母妊娠期高血压疾病儿脐血S100B蛋白水平与NBNA评分呈负相关(r=-0.596,P<0.01)。脐血S100B蛋白ROC曲线下面积为0.992,以95.04pg/ml作为S100B的最佳截取值时,诊断脑损伤的特异度94.0%、灵敏度95.7%。结论:NF-κB作为转录因子,参与了孕母妊娠期高血压疾病新生儿缺氧缺血性脑损伤的发生、发展。脐血S100B蛋白水平基本不受脐带组织S100B蛋白表达的影响,脐血S100B蛋白对早期诊断孕母妊娠期高血压疾病儿缺氧缺血性脑损伤具有特异性价值。
OBJECTIVE: To detect the expression of nuclear factor-kappa B (NF-κB) and S100B in umbilical cord tissue and the level of S100B in umbilical cord blood of neonates with hypertensive disorder complicating pregnancy, and to explore the early role of NF-κB and S100B in neonatal brain injury in hypertensive disorder of pregnancy Diagnostic value. Methods: Ninety-seven newborns with hypertensive disorder complicating pregnancy were selected and divided into two groups according to their NBNA score: from 3 to 7 days after birth or from 3 to 7 days after 40 weeks of gestational age correction. 35 were divided into brain injury group,> 35 were divided into non-brain injury group; while 20 healthy newborns were selected as the control group. Immunohistochemistry was used to detect the expression of κB and S100B, and the level of S100B protein was detected by enzyme linked immunosorbent assay (ELISA). Results: The expression of NF-κB in umbilical cord tissue was not significantly different (P> 0.05). However, the expression of NF-κB in umbilical cord tissue between the brain injury group and the non-brain injury group was not significantly different There was a significant difference (P <0.05). There was no significant difference in the expression of S100B in the umbilical cord between the brain injury group, the non-brain injury group and the normal control group (P> 0.05). The level of S100B protein in the cord blood of the brain injury group was significantly higher than that of the non-brain injury group The level of S100B protein in umbilical cord blood of non-brain injury group was also significantly higher than that of the normal control group (P <0.05). The level of S100B protein in pregnant women with gestational hypertension was negatively correlated with NBNA score (r = -0.596, P <0.01). The area under the curve of ROC curve of cord blood S100B protein was 0.992. When the optimal cut-off value of S100B was 95.04 pg / ml, the specificity of brain injury was 94.0% and the sensitivity was 95.7%. CONCLUSION: NF-κB, as a transcription factor, is involved in the occurrence and development of hypoxic-ischemic brain damage in newborn infants with gestational hypertension. Umbilical cord blood S100B protein levels are not affected by umbilical cord S100B protein expression, cord blood S100B protein early diagnosis of gestational hypertension in pregnant women with hypoxic-ischemic brain damage has a specific value.