血糖异常足月新生儿血清S100-β蛋白水平和振幅整合脑电图变化及其临床意义

Changes of serum S100 calcium binding protein level and amplitude integrated electroencephalogram in full-term pathoglycemia neonates and their clinical significance

目的探讨血糖异常足月新生儿血清S100钙结合蛋白(S100-β)水平及振幅整合脑电图(aEEG)变化及其临床意义。方法选择2016年1月至2019年1月新乡市中心医院收治的62例足月新生儿为研究对象,根据血糖水平将新生儿分为血糖正常组(n=33)和血糖异常组(n=29),随访7d后根据颅脑核磁共振检查结果将血糖异常组新生儿再分为脑损伤组(n=13)和未损伤组(n=16)。采用酶联免疫吸附法检测所有新生儿血清S100-β水平,采用数字化振幅整合脑功能监护仪进行aEEG检查,比较不同血糖状态、不同预后新生儿血清S100-β蛋白水平及aEEG评分差异;采用受试者工作特征曲线(ROC)分析血清S100-β水平、aEEG评分在血糖异常足月新生儿预后中的评估价值。结果血糖异常组新生儿血清S100-β水平、aEEG评分高于血糖正常组(P<0.05);脑损伤组新生儿血清S100-β水平、aEEG评分高于未损伤组(P<0.05);血清S100-β水平评估血糖异常足月新生儿预后的灵敏度、特异度、ROC曲线下面积分别为91.5%、89.7%、0.957;aEEG评分评估血糖异常足月新生儿预后的灵敏度、特异度、ROC曲线下面积分别为80.9%、76.8%、0.832。结论血清S100-β水平、aEEG评分在血糖异常足月新生儿预后评估中有明确应用优势,或可作为血糖异常足月新生儿脑损伤的有效预测标志物。

Objective To investigate the changes of serum S100 calcium binding protein( S100-β) level and amplitude integrated electroencephalogram( a EEG) of full-term pathoglycemia neonates and their clinical significance.Methods A total of 62 full-term neonates who were admitted to Xinxiang Central Hospital from January 2016 to January 2019 were enrolled. The neonates were divided into normal blood glucose group( n = 33) and abnormal blood glucose group( n =29) according to blood glucose level. According to craniocerebral magnetic resonance imaging examination results after 7 days of follow-up,the neonates in the abnormal blood glucose group were divided into brain injury group( n = 13) and non-injury group( n = 16). The level of serum S100-β of all neonates was detected by enzyme-linked immunosorbent assay. The a EEG examination was performed by digital amplitude integrated brain function monitor. The serum S100-β level and a EEG score of neonates with different blood glucose status and prognosis were compared. The estimated value of serum S100-β level and a EEG score in prognosis of full-term pathoglycemia neonates was analyzed by receiver operating characteristic curve( ROC).Results The serum S100-β level and a EEG score in the abnormal blood glucose group were higher than those in the normal blood glucose group( P < 0. 05). The serum S100-β level and a EEG score in the brain injury group were higher than those in the non-injury group( P < 0. 05). The sensitivity,specificity and area under ROC curve of serum S100-β level in evaluating the prognosis of neonates with abnormal blood glucose were 91. 5%,89. 7% and 0. 957,respectively. The sensitivity,specificity and area under ROC curve of a EEG score in evaluating the prognosis of neonates with abnormal blood glucose were 80. 9%,76. 8% and 0. 832,respectively. Conclusion Serum S100-β level and a EEG score have clear advantages in the evaluation of prognosis of infants with abnormal blood glucose,or they can be used as effective predictors of brain injury in infants with abnormal blood glucose.