振幅整合脑电图联合AOPP、sLOX-1在早产儿脑损伤早期诊断中价值

Value of aEEG combined with AOPP and sLOX-1 in the early diagnosis of brain injury in premature infants

目的探讨振幅整合脑电图(aEEG)联合晚期氧化蛋白产物(AOPP)、可溶性凝集素样氧化型低密度脂蛋白受体1(sLOX-1)在早产儿脑损伤早期诊断中的价值。方法选择2018年9月至2019年9月有脑损伤高风险因素的住院早产儿63例,根据磁共振成像结果分成脑损伤组(27例)及非脑损伤组(30例)。于早产儿出生后6小时内行aEEG监测;在早产儿出生后6小时、3天、7天时采集血浆,以酶联免疫吸附法(ELISA)检测AOPP、sLOX-1;行logistic回归分析,创建受试者工作特征曲线(ROC),计算aEEG、AOPP、sLOX-1单独及联合检测对诊断早产儿脑损伤的灵敏度、特异度及曲线下面积(AUC)。结果两组间胎龄、出生体质量、性别差异均无统计学意义(P>0.05)。脑损伤组aEEG异常率(88.9%)高于非脑损伤组(26.7%),aEEG图形的连续性(Cy)、睡眠觉醒周期(Co)、宽带(B)评分及总评分(T)低于非脑损伤组,差异均有统计学意义(P<0.05)。脑损伤组生后6小时、3天、7天时血浆sLOX-1及AOPP水平高于非脑损伤组,差异均有统计学意义(P<0.001)。血浆sLOX-1及AOPP联合aEEG诊断早产儿脑损伤的灵敏度、特异度及AUC高于单项检测,分别为0.93、0.90和0.96。结论aEEG联合AOPP、sLOX-1可明显提高早产儿脑损伤早期诊断效能,对其早期诊断具有较好的临床应用价值。

Objective To investigate the value of amplitude integrated electroencephalogram(aEEG),advanced oxidation protein product(AOPP)and soluble form of lectin-like oxidized low-density lipoprotein receptor-1(sLOX-1)in the early diagnosis of brain injury in preterm infants.Methods A total of 63 premature infants in NICU with high risk of brain injury were selected from September 2018 to September 2019.According to MRI,the patients were divided into brain injury group(27 cases)and non brain injury group(30 cases).All of them were detected by aEEG within 6 hours after birth.Meanwhile,plasma was collected at 6 th hour,3th day and 7th day after the birth of thepremature infants.The indexes were analyzed by logistics and the working characteristic curve of the subjects,and the aEEG,sLOX-1 and AOPP wereused to calculate the sensitivity,specificity and AUC of single and combined detection.Results There was no significant difference in gestational age,birth weight and gender between the two groups(P>0.05).The abnormal rate of aEEG in brain injury group(88.9%)was significantly higher than that in non brain injury group(26.7%)(P<0.001).The scores of Cy,Co,B and total of aEEG in brain injury group were significantly lower than those in non brain injury group(P<0.05).There was no significant difference in LB between the two groups(P=0.07).The levels of sLOX-1 and AOPP in the plasma of the brain injury group were significantly higher than those of the non brain injury group(P<0.001).The sensitivity,specificity and area under the curve of the combined diagnosis were 0.93,0.90 and 0.96,respectively.Conclusion aEEG combined with AOPP and sLOX-1 can significantly improve the early diagnosis of brain injury in preterm infants,and has a better clinical value in the early diagnosis of brain injury in preterm infants.