血清神经元特异性烯醇化酶、血浆神经肽Y及振幅整合脑电图动态变化早期预测窒息新生儿缺血缺氧性脑病的意义  

The significance of dynamic changes of serum neuron-specific enolase,plasma neuropeptide Y and amplitude-integrated EEG in early prediction of hypoxic-ischemic encephalopathy in asphyxiatedneonates

作　　者：梁大康 李雪萍 陈洁静[1] LIANG Dakang;LI Xueping;CHEN Jiejing(Sihui People's Hospital,Guangdong,Sihui 526200,China)

机构地区：[1]广东省四会市人民医院,广东四会526200

出　　处：《中国医药科学》2021年第10期89-92,109,共5页China Medicine And Pharmacy

基　　金：广东省肇庆市科技创新指导类项目(201904031023)。

摘　　要：目的探究血清神经元特异性烯醇化酶(NSE)、血浆神经肽Y(NPY)及振幅整合脑电图(aEEG)动态变化早期预测窒息新生儿缺血缺氧性脑病(HIE)的意义。方法收集2018年6月至2020年6月于我院NICU治疗足月窒息新生儿116例,为研究组,收集同期新生儿病房中无脑损伤足月新生儿58例,为对照组,且研究组据诊断标准均分为研究A组(轻度窒息)与研究B组(重度窒息)。均行aEEG动态监测,检测血清NSE、血浆NPY,分析三组不同时间点血清NSE水平及血浆NPY水平、aEEG背景活动监测结果,对比研究A组与研究B组HIE早期预测价值。结果研究B组娩出24 h、3 d、7 d的血清NSE及血浆NPY水平均高于对照组、研究A组(P<0.05);新生儿娩出后6 h、3 d及7 d时间点aEEG背景活动异常比例与其窒息程度呈正相关(P<0.05);研究A组窒息新生儿HIE早期预测符合率为91.4%;研究B组早期预测符合率为93.1%。结论aEEG动态监测及血清NSE、血浆NPY检查早期预测窒息新生儿HIE,具有显著应用价值,且能预测不同窒息程度HIE,值得推广。Objective To probe into the significance of dynamic changes of serum neuron-specific enolase(NSE),plasma neuropeptide Y(NPY)and amplitude-integrated EEG(aEEG)in early prediction of hypoxic-ischemic encephalopathy(HIE)in asphyxiatedneonates.Methods A total of 116 full-term asphyxiated neonates treated in the NICU of our hospital from June 2018 to June 2020 were collected as the study group,while 58 full-term neonates without brain injury in NICU during the same time were collected as the control group,and the study group was equally divided into the study group A(mild asphyxia)and the study group B(severe asphyxia)according to the diagnostic criteria.In all the three groups,aEEG dynamic monitoring was performed,and serum NSE and plasma NPY were examined.The levels of serum NSE and plasma NPY and the monitoring results of aEEG background activities in the three groups at different time points were analyzed,and the value of early prediction of HIE in the study group A and the study group B was compared.Results The levels of serum NSE and plasma NPY in the study group B were higher than those in the control group and the study group A at 24 h,3 d and 7 d after delivery(P<0.05).There was a positive correlation between the abnormal proportion of aEEG background activities and asphyxia degree at 6 h,3 d and 7 d after delivery(P<0.05).The accuracy rate of early prediction of HIE in the asphyxiatedneonates of the study group A was 91.4%,while that of the study group B was 93.1%.Conclusion AEEG dynamic monitoring and the examination of serum NSE and plasma NPY can not only predict the HIE of asphyxiated neonates in early stage,but also predict HIE of different asphyxiation degrees.They have significant application value,which is worthy of promotion.

关 键 词：血清NSE 血浆NPY AEEG 窒息新生儿 HIE 

分 类 号：R722[医药卫生—儿科]