血清HO-1、NBNA评分在早产儿脑损伤中变化分析及对脑发育预后评估的价值  

Analysis of the changes of serum HO-1 and NBNA scores in premature infants with brain injury and their value in evaluating the prognosis of brain development

作　　者：邓琳凡 王敏 康晓萍 伍术晶 DENG Linfan;WANG Min;KANG Xiaoping;WU Shujing(Mianyang Hospital Affiliated to Medical College of University of Electronic Science and Technology/Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院/绵阳市中心医院儿科,四川绵阳621000

出　　处：《国际检验医学杂志》2022年第5期554-558,共5页International Journal of Laboratory Medicine

基　　金：四川省绵阳市卫生计生委医学科研项目(201920)。

摘　　要：目的探讨血清血红素加氧酶-1(HO-1)、新生儿神经行为测定(NBNA)评分在早产儿脑损伤中的变化情况,并分析二者对脑发育预后评估的价值。方法纳入2017年9月至2020年4月于该院产科分娩的早产儿130例,根据有无脑损伤分成脑损伤组(n=52)、对照组(n=78),并按照脑损伤组的胎龄分成胎龄<32周(A组,n=16)、胎龄32~<34周(B组,n=19)、胎龄34~36周(C组,n=17)。比较脑损伤组、对照组出生后第3、7、14天的血清HO-1水平与NBNA评分,并分析不同胎龄脑损伤患儿的血清HO-1水平与NBNA评分变化。在脑损伤患儿矫正胎龄至40周后随访6个月,经振幅整合脑电图(aEEG)评估脑发育情况,并分成良好组(n=39)、不良组(n=13),绘制受试者工作特征曲线(ROC)分析血清HO-1、NBNA评分对脑发育预后的评估价值。结果脑损伤组第3、7、14天的血清HO-1水平及均值高于对照组,而NBNA评分及均值低于对照组,差异有统计学意义(P<0.05)。A组第3、7、14天的血清HO-1水平及均值高于B、C组,且B组高于C组,而A组第3、7、14天的NBNA评分及均值低于B、C组,且B组低于C组,差异有统计学意义(P<0.05)。不良组第3、7、14天的血清HO-1水平及均值高于良好组,NBNA评分及均值低于良好组,差异有统计学意义(P<0.05)。血清HO-1水平及NBNA评分单独与联合评估脑损伤患儿脑发育预后的曲线下面积(AUC)分别为0.724(95%CI:0.570~0.878,灵敏度=69.20%,特异度=64.10%)、0.748(95%CI:0.592~0.903,灵敏度=61.50%,特异度=82.10%)、0.846(95%CI:0.714~0.978,灵敏度=84.60%,特异度=84.60%)。结论脑损伤患儿的血清HO-1水平增高,而NBNA评分降低,临床可通过测定二者水平,分析患儿脑发育。Objective To explore the changes of serum heme oxygenase-1(HO-1)and neonatal behavioral neurological assessment(NBNA)scores in premature infants with brain injury,and to analyze the value of them in evaluating the prognosis of brain development.Methods One hundred and thirty cases of premature infants who were delivered in the obstetrics department of Mianyang Hospital Affiliated to Medical College of University the hospital from September 2017 to April 2020 were included.According to the presence or absence of brain injury,they were divided into brain injury group(n=52)and control group(n=78).According to the gestational age of the brain injury group,it was divided into the gestational age less than 32 weeks group(group A,n=16),the gestational age group of 32 to<34 weeks(group B,n=19),The levels of HO-1 and NBNA scores were compared between brain injury group and control group on the 3rd,7th and 14th day after birth.The changes of serum HO-1 level and NBNA score in children with brain injury at different gestational ages were analyzed.The children with brain injury were followed up for 6 months after corrected gestational age of 40 weeks.The brain development was assessed by amplitude integrated electroencephalogram(aEEG)and divided into good group(n=39)and bad group(n=13).Receiver operating characteristic(ROC)curve was drawn to analyze the value of serum HO-1 and NBNA scores in evaluating the prognosis of brain development.Results The level and mean value of serum HO-1 in the brain injury group were higher than those in the control group on the 3rd,7th and 14th day,while the NBNA score and mean value were lower than those in the control group,the differences were statistically significant(P<0.05).The level and mean value of HO-1 in group A were higher than those in group B and C on 3rd,7th and 14th,and that in group B was higher than that in group C.The NBNA score and mean value in group A on 3rd,7th and 14th were lower than those in group B and C,and that in group B was lower than that in group C,the differenc

关 键 词：脑损伤 早产儿 血红素加氧酶-1 新生儿神经行为测定 脑发育 

分 类 号：R722.6[医药卫生—儿科]