aEEG联合NSE、NPY在新生儿高胆红素血症诊治中的应用  

Application of aEEG combined with NSE and NPY in the diagnosis and treatment of neonatal hyperbilirubinemia

作　　者：王云 杨冬 崔湘君 周彬 WANG Yun;YANG Dong;CUI Xiangjun;ZHOU Bin(Department of Pediatrics,Xuzhou Central Hospital,Xuzhou Clinical School of Xuzhou Medical University,Xuzhou,Jiangsu 221009,China)

机构地区：[1]徐州医科大学徐州临床学院,徐州市中心医院儿科,江苏徐州221009

出　　处：《徐州医科大学学报》2024年第9期668-672,共5页Journal of Xuzhou Medical University

基　　金：江苏省妇幼健康项目(F202156);徐州市卫生健康委科技项目(XWKYHT20210536);徐州医科大学附属医院发展基金项目(XYFM2021025);徐州市医学领军人才培养项目(XWRCHT20210039)。

摘　　要：目的 探究振幅整合脑电图(aEEG)动态变化及血清神经元特异性烯醇化酶(NSE)、血浆神经肽Y(NPY)在新生儿高胆红素血症诊治中的意义。方法 选取2022年1月—12月于徐州市中心医院新生儿重症监护病房收治的足月新生儿高胆红素血症患儿156例。根据胆红素致神经功能障碍(BIND)评估量表得分,将上述患儿分为2组:无脑损伤者为对照组(n=108),脑损伤者为研究组(n=48)。2组患儿均接受aEEG动态监测。比较2组患儿血清NSE、血浆NPY水平、aEEG背景活动,评估血清NSE、血浆NPY和aEEG单独检测或三者联合对新生儿高胆红素脑损伤的早期预测价值。结果 研究组的血清NSE和血浆NPY水平显著高于对照组,差异有统计学意义(P<0.001)。NSE水平和NPY水平与新生儿高胆红素血症脑损伤的发生呈正相关,aEEG背景活动异常也与新生儿高胆红素血症脑损伤的发生呈正相关,差异均有统计学意义(P<0.05)。NSE水平、NPY水平和aEEG背景活动对新生儿高胆红素血症脑损伤早期预测的曲线下面积(AUC)分别是0.918、0.877和0.853,三者联合预测的AUC为0.987。结论 aEEG动态监测及血清NSE、血浆NPY水平联合检测能够更好地早期预测新生儿高胆红素血症脑损伤,值得临床推广。Objective To evaluate the application of dynamic changes in amplitude-integrated electroencephalography(aEEG),serum neuron-specific enolase(NSE),and plasma neuropeptide Y(NPY)in the diagnosis and treatment of neonatal hyperbilirubinemia.Methods A total of 156 full-term newborns with hyperbilirubinemia who were admitted to the neonatal intensive care unit of Xuzhou Central Hospital from January to December 2022 were selected.According to the bilirubin-induced neurologic dysfunction(BIND)assessment scale scores,the patients were divided into two groups:a control group(n=108,with no brain injury)and a study group(n=48,with brain injury).Both groups underwent dynamic aEEG monitoring.Both groups were compared for their levels of serum NSE and plasma NPY and aEEG background activity,in order to assess the predictive value of serum NSE,plasma NPY,and aEEG alone or in combination,for early detection of brain injury due to hyperbilirubinemia in newborns.Results The serum NSE and plasma NPY levels in the study group were significantly higher than those in the control group,with statistical differences(P<0.001).Both NSE and NPY levels were positively correlated with the occurrence of brain injury in newborns with hyperbilirubinemia.Abnormal aEEG background activity was also positively correlated with the occurrence of brain injury in newborns with hyperbilirubinemia,with significant differences(P<0.05).The area under the curve(AUC)of early prediction of brain injury in newborns with hyperbilirubinemia was 0.981 for NSE levels,0.877 for NPY levels,and 0.853 for aEEG background activity;the AUC for the combined prediction was 0.987.Conclusions The combination of dynamic aEEG monitoring and measurements of serum NSE and plasma NPY levels provides better early prediction of brain injury in newborns with hyperbilirubinemia,which is worthy of clinical promotion.

关 键 词：振幅整合脑电图 血清神经元特异性烯醇化酶 血浆神经肽Y 新生儿高胆红素血症 胆红素神经功能障碍 

分 类 号：R722.1[医药卫生—儿科]