内源性一氧化碳在新生儿缺氧缺血性脑病预后的早期评估中的作用  

Role of Endogenous Carbon Monoxide for Early Assessment of Prognosis of Neonatal Hypoxic Ischemic Encephalopathy

作　　者：黄燕萍[1] 王安生[1] 艾婷[1] 史瑞明[1] 辛华[1] 邓素莲[1] 罗树舫[1] 李改莲[1] 

机构地区：[1]西安交通大学第一医院儿科,西安市710061

出　　处：《中国医院用药评价与分析》2004年第1期40-42,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨内源性一氧化碳(CO)、新生儿行为神经测定(NBNA)、临床分度法和CT分度法等方法在新生儿缺氧缺血性脑病(HIE)预后判断早期评估中的意义。方法:对30例HIE患儿在生后第2天检测血浆CO水平,生后7天内进行临床分度、CT分度和NBNA评分,于生后6月～1岁进行神经发育随访,10例足月新生儿为对照组。结果:HIE组血浆CO浓度为(2.19±0.46)mg/L明显高于对照组(0.46±0.17)mg/L(P<0.001);血浆CO浓度分别与HIE临床分度、CT分度呈正相关,与NBNA评分呈负相关;临床分度法、CT分度法、NBNA及血浆CO浓度检测预测预后的敏感性分别为100％、100％、85.71％和83.33％,特异性分别为45.45％、45.45％、51.66％和58.33％。结论:临床分度法是预测HIE预后的基础指标,内源性一氧化碳浓度检测预测HIE预后的特异性高,可作为早期评估HIE预后的参考指标。OBJECTIVE: To study the effects of different methods on determining early prognosis of neonatal hypoxic ischemic encephalopathy. METHODS: The levels of plasma carbon monoxide(CO) were detected in 30 neonates with HIE on the second day after birth. The brain CT, neonatal behavioral neurological assessment (NBNA) were performed within 7 days after birth to assess the degree of brain injury. Development of intelligence was tested during 6 months - 1 year old. Ten healthy neonates were chosen as controls. RESULTS: Plasma CO level of HIE neonates(2.19 ± 0.46mg/L) was significantly higher than that of the normal control (0.46± 0.17mg/L). The level of plasma CO was positively correlated with clinical degree of HIE and degree of CT, but negatively correlated with NBNA. The sensitivity of clinical degree, CT degree, NBNA, plasma CO levels to predict prognosis was 100%, 100%, 85.71% and 83.33%, respectively. The specificity of them was 45.45%, 45.45%, 51.66% and 58.33%, respectively. CONCLUSION: Clinical degree is a basic marker of predicting prognosis of HIE, level of plasma CO has a better sensitivity in determining prognosis of HIE, which is taken as the reference index for early assessment of HIE prognosis.

关 键 词：内源性一氧化碳 新生儿缺氧缺血性脑病 新生儿行为神经测定 NBNA 神经发育 

分 类 号：R722.12[医药卫生—儿科]