To evaluate the clinical value of serum heme oxygenase-1 (HO-1) in predicting brain injury and short-term prognosis of premature infants.

From September 2017 to September 2019, a total of 120 premature infants hospitalized in neonatal intensive care unit of Clinical Medical College of Yangzhou University were included as subjects. According to head ultrasound and MRI results, 120 neonates were divided into a periventriclar-intraventricular hemorrhage (PIVH) group (n=35), a periventricular leukomalacia (PVL) group (n=15), and a no brain injury group (n=70). Serum HO-1 and interleukin-6 (IL-6) levels, amplitude-integrated electroencephalogram (aEEG) score, and neonatal behavioral neurological assessment (NBNA) score were recorded and compared. The receiver operating characteristic curves (ROC) of serum HO-1 and IL-6 levels, aEEG score, and NBNA score were plotted to calculate their sensitivity and specificity in the prediction of brain injury and short-term prognosis in premature infants based on the area under the ROC curve (AUC).

Serum HO-1 and IL-6 levels in the PIVH group and PVL group at different time points were significantly higher than those of the non-brain injury group, while aEEG score within one week was significantly lower than that of the non-brain injury group (P＜0.01). aEEG and NBNA scores in the PIVH and PVL group were significantly lower than those of the non-brain injury group at 40 weeks of gestation age (P＜0.01). Serum HO-1 was positively correlated with serum IL-6 (r = 0.814, P＜0.01), while it was negatively correlated with aEEG score within one week (r=-0.671, P＜0.01). Serum HO-1 was negatively correlated with aEEG score and NBNA score at 40 weeks of gestation (r=-0.631 and -0.666, respectively, P＜0.01). The areas under the ROC curves of serum HO-1 and IL-6 levels and aEEG score within a week were 0.812, 0.917, and 0.901, respectively; the corresponding sensitivities were 85.3%, 93.0% and 88.2%, and the corresponding specificities were 84.0%, 86.1%, and 96.7%, respectively. The area under the ROC curve of aEEG and NBNA scores at 40 weeks of gestation were 0.809 and 0.851, respectively; the sensitivities were 87.3% and 84.5%, and the specificities were 89.1% and 96.2%, respectively.

Serum HO-1 can be used as a sensitive and specific index to predict brain injury and short-term prognosis of premature infants, which has appreciated clinical application value.