杨英阁;张晋雷;薄延桥;

• 1:南阳医学高等专科学校第一附属医院

摘要(Abstract)：

目的探讨振幅整合脑电图(aEEG)联合血清学指标在早期诊断足月新生儿脑损伤中的价值。方法选取南阳医学高等专科学校第一附属医院治疗的86例脑损伤足月新生儿为实验组,选取同期出生无脑损伤足月新生儿86例为对照组,监测所有受试者出生后6h内aEEG,出生后第1、3、7天检测血清神经元特异性烯醇化酶(NSE)、S100β蛋白、乳酸。采用受试者工作特征(ROC)分析血清NSE、S100β蛋白、乳酸联合aEEG在足月新生儿脑损伤早期诊断中的价值。结果实验组出生后第1、3、7天血清NSE、S100β蛋白、乳酸水平均高于对照组(P<0.05);随着时间推移实验组血清NSE、S100β蛋白、乳酸水平均明显降低(P<0.05);86例有脑损伤的足月新生儿中aEEG正常24例(27.91%),轻度异常39例(45.35%),重度异常23例(26.74%)。其中MRI结果异常的55例中,aEEG同时异常者52例,aEEG监测与头颅MRI具有一致性。有脑损伤的足月新生儿出生后第1、3、7天,NSE第1天诊断价值最高,ROC曲线下面积(95%CI)为0.762(0.503～0.918),敏感度84.10%,特异度74.03%。S100β第3天诊断价值最高,ROC曲线下的面积(95%CI)为0.731(0.729～0.988),敏感度为82.11%,特异度为76.24%;乳酸第1天诊断价值最高,ROC曲线下面积(95%CI)为0.7516(0.618～0.907),敏感度82.16%,特异度75.43%;aEEG监测ROC曲线下的面积(95%CI)为0.815(0.641～0.947),敏感度为90.27%,特异度为88.81%;血清NSE、S100β蛋白、乳酸联合aEEG诊断价值最高,ROC曲线下的面积(95%CI)为0.912(0.841～0.987),敏感度为100.00%,特异度为98.64%。结论血清学指标对足月新生儿脑损伤具有较高的诊断价值,因半衰期影响,诊断价值随着日龄增加而降低,联合振幅整合脑电图可以弥补血清学指标后期诊断的不足,为足月新生儿脑损伤早期治疗提供重要依据。

关键词(KeyWords)： 振幅整合脑电图;血清学指标;足月新生儿;脑损伤;脑功能监测

Abstract:

Keywords:

基金项目(Foundation): 河南省高等学校重点科研项目计划(编号:16B320018)

作者(Authors): 杨英阁;张晋雷;薄延桥;

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