Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy

Diagnostics

卷:11

Chin-Sheng Yu¹  Inn-Chi Lee²  Swee-Hee Wong²  Xing-An Wang³ 

[1] Department of Information Engineering and Computer Science, and Master’s Program in Biomedical Informatics and Biomedical Engineering, Feng Chia University, Taichung 40201, Taiwan;

[2] Division of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;

[3] Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;

关键词: newborn;    hypoxic-ischemic encephalopathy;    biomarker;    MRI;    lactate;   

DOI  :  10.3390/diagnostics11050897

来源: DOAJ

【 摘 要 】

Background: Identifying an effective method for the early diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) would be beneficial for effective therapies. Methods: We studied blood biomarkers before 6 h after birth to correlate the degree of neonatal HIE. A total of 80 patients were divided into group 1 (mild HIE) and group 2 (moderate or severe HIE). Then, 42 patients from group 2 received hypothermia therapy and were further divided into group 3 (unremarkable or mild MRI results) and group 4 (severe MRI results). Results: Between groups 1 and 2, lactate, creatinine, white blood cells, and lactate dehydrogenase (LDH) were significantly different. Between groups 3 and 4, lactate, prothrombin time, and albumin were significantly different. Sarnat staging was based on our observation that more than 45 mg/dL of lactate combined with more than 1000 U/L of LDH yielded the highest positive predictive value (PPV) (95.7%; odds ratio, 22.00), but a low negative predictive value (NPV) for moderate or severe HIE. Using more than 45 mg/dL of lactate yielded the highest NPV (71.4%) correlated with moderate or severe HIE. Conclusions: Lactate combined with LDH before 6 h after birth yielded a high PPV. Using combined biomarkers to exclude mild HIE, include moderate or severe HIE, and initialize hypothermia therapy is feasible.

【 授权许可】

Unknown