Predictive Value of Middle Cerebral Artery Transcranial Doppler Ultrasound Hemodynamic Parameters and Serum Netrin-1 Level on Disease Outcome in Children with HIE

YANG Xiaofeng; WANG Yingyun; WANG Lifang

doi:10.3969/j.issn.1004-437X.2025.03.012

Abstract：Objective To explore the predictive value of transcranial Doppler ultrasound hemodynamic parameters of middle cerebral artery(MCA)and serum netrin-1 level in the prognosis of neonatal hypoxic ischemic encephalopathy(HIE).Methods A total of 108 children with HIE in the First Affiliated Hospital of Henan University of Science and Technology from December 2021 to August 2023 were collected and divided into good group(78 cases)and bad group(30 cases)according to whether the treatment was effective or not.The general data,MCA hemodynamic parameters[resistance index(RI),end diastolic velocity(Vd),peak systolic velocity(Vs),mean flow velocit(Vm)]and serum netrin-1 levels of the two groups were compared,and the influencing factors of poor prognosis of HIE were analyzed.The correlation and combined predictive value were analyzed by Spearman method and receiver operating characteristic(ROC)curve.Results The proportion of patients with no early intervention,severe disease and 10 min Apgar score≥4 in the adverse group was higher than that in the good group(P＜0.05).The levels of Vd,Vs,Vm and serum netrin-1 in the good group were higher than those in the bad group,and the RI value was lower than that in the bad group(P＜0.05).Vd,Vs,Vm,RI,serum netrin-1 level,no early intervention,disease severity,and 10 min Apgar score were the influencing factors of poor prognosis in children with HIE(P＜0.05).Vd,Vs,Vm and serum netrin-1 were negatively correlated with prognosis,while RI was positively correlated with prognosis(P＜0.05).The AUC of combining Vd,Vs,Vm and serum netrin-1 level to predict the poor prognosis of HIE children was 0.864,the best predictive sensitivity was 93.33％,and the specificity was 79.49％.Conclusion MCA transcranial Doppler ultrasound hemodynamic parameters and serum netrin-1 level can be used as auxiliary indicators to predict the prognosis of HIE children,and the combined predictive of the two tests can significantly improve the prediction efficiency.