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目的研究足月新生儿获得性脑损伤早期相关血清指标探查与脑电图监测及其预后。方法选取2015年10月-2017年1月在该院接受诊治的获得性脑损伤足月新生儿50例(研究组),另选取同期出生的无脑损伤足月新生儿50例(对照组)。两组新生儿均在出生后2~3 d应用酶联免疫吸附法检测血清髓鞘碱性蛋白(MBP)、神经细丝酸性蛋白(GFAP)及肌酸激酶脑型同工酶(CK-BB)表达水平,于出生后3~5 d行动态脑电图监测,并在出生后3个月、12个月时进行随访,行脑电图复查。结果研究组患儿血清MBP、GFAP、CK-BB表达水平均高于对照组(P<0.05);研究组患儿最长背景抑制时间高于对照组(t=13.285,P<0.05);研究组3例出现持续低电压表现,3例背景波率慢,5例最长背景抑制时间>20 s;随访显示研究组患儿中9例神经行为发育评估显著低于正常新生儿,对照组中1例神经行为发育评估显著低于正常新生儿,Bayley婴幼儿发育量表中心理运动发育指数(PDI)及智力指数(MDI)均<70。结论足月新生儿获得性脑损伤早期相关血清指标水平明显高于正常新生儿,可能与新生儿早期脑损伤程度、预后等因素有关,脑电图监测可以作为临床评估新生儿早期脑损伤的指标。
Objective To investigate early detection of serum markers and EEG monitoring of full-term newborn acquired brain injury and its prognosis. Methods Fifty newborn infants with acquired brain injury (study group) receiving treatment from October 2015 to January 2017 in our hospital were enrolled in this study. Fifty newborn infants without term brain injury (control group) . Serum levels of MBP, GFAP and CK-BB were measured by enzyme-linked immunosorbent assay (ELISA) at 2 to 3 days after birth in both groups of neonates. ), And dynamic electroencephalogram was performed 3 to 5 days after birth and was followed up at 3 months and 12 months after birth for EEG examination. Results The serum levels of MBP, GFAP and CK-BB in study group were significantly higher than those in control group (P <0.05). The longest background inhibition time in study group was higher than that in control group (t = 13.285, P <0.05) Three patients showed sustained low voltage performance, three patients had slow background wave rate, and the longest background suppression time was longer than 20 s in five patients. The follow-up showed that the neurobehavioral assessment of 9 patients in study group was significantly lower than that in normal neonates, The neurobehavioral development in 1 patient was significantly lower than that in normal newborns. The Bayley Infant Developmental Scale (PDI) and Intelligence Index (MDI) were all <70. Conclusions Early serum-related serum markers of full-term neonatal acquired brain injury are significantly higher than those of normal newborns, which may be related to the degree of early brain injury and prognosis of neonates. EEG monitoring can be used as an index to evaluate early neonatal brain injury .