关键词: 新生儿高胆红素血症, 神经肽Y, 胰岛素样生长因子-1, 降钙素原

Abstract: Objective To investigate the clinical value of serum neuropeptide Y (NPY), insulin-like growth factor-1 (IGF-1) and procalcitonin (PCT) in neonates with hyperbilirubinemia (NHB).Methods 94 neonates with NHB admitted to the Department of Pediatrics of Haian People’s Hospital from January 2019 to June 2021 were enrolled into the observation group. According to the serum total bilirubin (TBil) level within 24 hours after admission, they were divided into mild group (n=37), moderate group (n=32) and severe group (n=25). According to the results of head MRI, they were divided into two groups: the group with abnormal globus pallidus signal (n=10 cases) and the group without abnormal globus pallidus signal (n=15 cases). Thirty-five healthy neonates who delivered at the same time were included in the control group. Serum levels of NPY, IGF-1, PCT, hemoglobin (Hb), alanine aminotransferase (ALT), albumin (Alb), TBil, unbound bilirubin (UCB) and urea nitrogen (BUN) were detected. The serum levels of NPY, IGF-1 and PCT, ALT, Alb, UCB, Hb, BUN and cTnT were compared between the observation group and the control group. The serum levels of NPY, IGF-1 and PCT in the severe and non-abnormal globus pallidus signal group were compared, and the correlation between serum levels of NPY, IGF-1 and PCT and liver function indexes such as ALT, Alb, TBil and UCB was analyzed by Pearson.Results Serum NPY and PCT levels in severe subgroup were (6.53 ± 1.08) ng/L and (3.48 ± 0.74) ng/mL, which were higher than those in moderate subgroup [(5.82 ± 0.91) ng/L and (2.75 ± 0.58) ng/mL], in mild group [(4.48 ± 0.79) ng/L and (1.82 ± 0.43) ng/mL] and in control group [(3.06 ± 0.47) ng/L and (0.58 ± 0.17) ng/mL]. Serum IGF-1 level in severe subgroup was lower than that in moderate group [(30.92 ± 4.48) ng/mL], mild group [(36.74 ± 6.53) ng/mL] and control group [(49.56 ± 8.71) ng/mL], the difference was statistically significant (F=12.459, 26.385, 18.527, All P<0.05). The levels of ALT, UCB and cTnT in severe subgroup were significantly higher than those in moderate subgroup, mild subgroup and control group, showing a decreasing trend (P<0.01). Serum Alb and Hb levels in severe subgroup were significantly lower than those in moderate subgroup, mild subgroup and control group, with an increasing trend (P<0.05). Serum NPY and PCT levels in the subgroup with abnormal pallidus pallidus signal were (7.12 ± 1.24) ng/L and (4.05 ± 0.89) ng/mL, which were higher than those in the subgroup without abnormal pallidus signal [(6.08 ± 0.97) ng/L and (3.18 ± 0.67) ng/mL]. Serum IGF-1 level in the subgroup with abnormal pallidus signal was (20.37 ± 3.46) ng/mL, lower than that in the subgroup without abnormal pallidus signal [(27.18 ± 3.94) ng/mL], the difference was statistically significant (t=7.682, 6.925, 8.647, all P<0.05). Pearson correlation analysis showed that serum NPY and PCT levels were positively correlated with ALT, Alb, TBil and UCB liver function indexes, while serum IGF-1 levels were negatively correlated with liver function indexes (P<0.05).Conclusion Serum levels of NPY, IGF-1 and PCT are of high clinical value for disease monitoring and prognosis evaluation of NHB.

Key words: Neonates with hyperbilirubinemia, Neuropeptide Y, Insulin-like growth factor-1, Procalcitonin