关键词: tau蛋白, 新生儿, 缺血缺氧性脑病, 神经发育预后

Abstract: Objective To explore the relationship of serum tau protien levels with the severity and neurodevelopmental prognosis in neonatal hypoxic-ischemic encephalopathy (HIE ). Methods A total of 68 full-term neonates with HIE were enrolled,including 29 cases mild,21 moderate and 18 severe,and 16 cases without HIE(control group) were enrolled too.Serum samples were collected at day 0,3,5,7 and 14 after birth.Tau protein levels in each group were studied to reveal the relation between serum tau protiens levels and severity and prognosis in neonates with HIE. Results Tau protein in serum was changed with the trend of increasing and then decreasing.The peak concentration of serum tau protein was reached at 5 day and still remained high level at 14^th day.The serum tau protein level in control group was significantly lower than HIE groups at any time points(P<0.05).Serum tau protien level in severe group was significantly higher than other three group at all time points (P<0.05).After one year's follow-up,15 cases got a poor neurodevelopmental outcome:1 case in the mild group,4 cases in moderate group and 10 cases in severe group.Compared with other groups,the rate of poor neurodevelopmental outcome in severe group was significantly higher.Among those with a poor neurodevelopmental outcome,serum tau protein level was higher than the rest neonates with a good prognosis at different time points.No correlation was found between Apgar score and serum tau protien level at any time points (P>0.05).ROC analysis showed that serum tau protein level at the 14th day(>667.1 pg/ml) predict accurately of neurodevelopmental prognosis of HIE neonates:AUC=0.96,sensitivity 93.3%,specificity 90.57% and with the maximum positive predictive value(73.68%). Conclusion Serum tau protein can serve as a biomarker reflecting the severity and predicting the neurodevelopmental prognosis of neonates with HIE.

Key words: tau protein, neonates, hypoxic-ischemic encephalopathy, neurodevelopmental prognosis