The clinical significance of cord blood neutrophil gelatinase-associated lipocalin in neonates with perinatal hypoxic organ damage
10.3760/cma.j.issn.2096-2932.2023.10.006
- VernacularTitle:脐血中性粒细胞明胶酶相关脂质运载蛋白在新生儿出生时缺氧器官受损中的变化及临床意义
- Author:
Yu LIU
1
;
Yan ZHUANG
;
Xirong GAO
;
Lingyun YI
;
Bo LYU
;
Haijun XIANG
;
Jiren LIAO
Author Information
1. 湖南妇女儿童医院新生儿科，长沙 410000
- Keywords:
Newborn;
Cord blood neutrophil gelatinase-associated lipocalin;
Anoxia;
Organ damage
- From:Chinese Journal of Neonatology
2023;38(10):603-608
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the changes of cord blood neutrophil gelatinase-associated lipocalin (NGAL) under different levels of hypoxia at birth and its correlations with hypoxic organ damage (including liver, kidney and heart).Methods:From April to October 2022, all neonates born in our hospital were prospectively enroll in the study. The neonates without perinatal risk factors were assigned into the control group. The neonates with intrauterine distress or hypoxia during labor were assigned into the hypoxia group (no asphyxia at birth) and the asphyxia group (with asphyxia at birth). Cord blood was collected from the umbilical artery and cord blood gas (CBG) and NGAL were measured. Liver enzymes, kidney function and cardiac enzymes as biomarkers for hypoxic organ damage were measured 24~48 h after birth. The correlations of NGAL and the biomarkers were analyzed.Results:A total of 161 neonates were enrolled, including 91 in the control group, 49 in the hypoxia group and 21 in the asphyxia group. NGAL in the asphyxia group was significantly higher than the hypoxia group and the control group [(1.81±0.71) ng/ml vs. (1.22±0.53) ng/ml, (0.88±0.47) ng/ml], NGAL in the hypoxia group significantly higher than the control group ( P<0.05). NGAL was negatively correlated with Apgar score, pH and BE of CBG ( r<-0.3, P<0.05) and positively correlated with lactate, ALT, creatinine ( r>0.3, P<0.05). No significant correlations existed between NGAL and gender, gestational age, birth weight, mother's age, BMI and CK-MB ( P<0.05). ROC curve showed that sensitivity and specificity of NGAL for predicting hypoxic organ damage were 84.3% and 60.3%, respectively, with a cut-off value of 1.07 ng/ml. Conclusions:Cord blood NGAL may increase with the deterioration of hypoxia at birth and may be associated with hypoxic organ damage.
