目的探讨程序化细胞死亡基因5(programmed cell death 5,PDCD5)在新生儿缺氧缺血性脑病(hypoxicischcmic encephalopathy,HIE)血清中的表达及与细胞凋亡的关系,分析其与血清高敏C反应蛋白(high-sensitivity C-reactive protein hsCRP)水平及临床分度之间的相关性,为临床早期诊断及病情判断提供理论依据。方法选择70例HIE患儿,按临床分度(轻度、中度、重度)分为三个亚组,轻度组30例,中度组20例,重度组20例,同期出生的足月健康新生儿30例为对照组,采用酶联免疫吸附双抗体夹心ELISA法检测生后1、3、7d血清PDCD5水平,并检测其生后3、7d血清hsCRP水平。结果 HIE各组生后1d血清PDCD5开始升高,3d达高峰,7d下降。血清PDCD5水平在HIE各组中呈现据病情分度依次升高的变化规律,组间差异具有统计学意义(P〈0.01)。HIE病情越重,PDCD5升高越明显,HIE各组生后1d(r=0.851)、3d(r=0.932)、7d(r=0.773)血清PDCD5水平与病情分度呈正相关(P均〈0.001)。HIE各组生后3d和7d血清hsCRP水平均较对照组明显升高,差异有统计学意义(P〈0.01)。HIE患儿生后3d(r=0.604)、7d(r=0.379)血清PDCD5水平与血清hsCRP水平呈正相关(P均〈0.001)。结论 PDCD5可能参与了新生儿HIE中细胞凋亡的发生与发展。动态检测HIE患儿清中PDCD5和hsCRP水平对判断新生儿HIE的病情严重程度、评估预后有一定的临床价值。
Objective To investigate the expression of programmed cell death 5 (PDCD5) in serum of neonates with hypoxic ischemic encephalopathy (HIE) and its correlation with apoptosis, the level of high-sensitivity C-reactive protein (hs-CRP) and clinical degree,to provide a theoretical basis for clinical early diagnosis and judgment. Methods There were 70 cases of neonates with HIE admired in this study,which were divided into three subgroups (mild group 30 cases of,moderate group of 20 cases,severe group of 20 cases) according to the clinical degree. 30 cases of healthy full-term newborns was control group. The levels of PDCD5 in serum of all cases were detected at 1^st day,3rd day and 7^th day after born birth by en- zyme-linked immunosorbent double antibody sandwich method,at the same time the level of hs-CRP was detected at 3^rd day and 7th days. Results The levels of PDCD5 for all groups began to increase after birth,the maximum value appeared at 3rd day, and decreased in 7^th day;the difference among 1,3,7 day after birth was significant (P〈0.01). Serum PDCD5 levels in HIE groups were gradually increased with illness degree, and difference were significant between groups (P〈0.01). The levels of PDCD5 of 1^st day,3rd day and 7^th day after birth were positively correlated with HIE illness index (1^st day: r= 0.851,3rd day: r= 0. 932,7th day: r= 0. 773, P〈0.01), the more serious the HIE illness was, the more obvious rise of serum PDCD5 was. The levels of hs-CRP for groups of neonates at 3rd day and 7'h day after birth which were significant higher than that of control group with statistically significant differences (all P〈0.01). There were certain positively relation between the levels of PDCD5 and hs-CRP in 3~ day, 7th day after neonates birth (3rd day: r= 0. 604,7th day:r= 0. 379, P〈0. 001). Conclusion PDCD5 may be involved in occurrence and development of cell apoptosis in neonates HIE. There is certain clinical value to measure the levels of PDCD5 and hs-C