振幅整合脑电图评分、血清LDH水平对早产儿脑损伤的评估价值

The evaluation value of amplitude-integrated electroencephalogramscore and serum LDH level for brain injury in premature infants

目的:探讨早产儿振幅整合脑电图(aEEG)评分、血清乳酸脱氢酶(LDH)水平与脑损伤严重程度相关性,并分析其对脑损伤发生的评估价值。方法:回顾性选取2021年1月至2023年6月于漯河市中心医院出生的早产儿212例为研究对象,依据出生后是否发生脑损伤分为发生组86例、未发生组126例。比较两组aEEG评分、血清LDH水平及出生后5 min Apgar评分、新生儿神经学评分(NBNA)。依据脑损伤严重程度脑损伤发生组分为轻度27例、中度38例、重度21例,比较两组aEEG评分、血清LDH水平,从而分析aEEG评分、血清LDH水平与脑损伤严重程度、出生后5 min Apgar评分、NBNA评分相关性,分析脑损伤发生的影响因素,分析aEEG评分、血清LDH水平对脑损伤的评估价值。结果:发生组aEEG评分、出生后5 min Apgar评分、NBNA评分低于未发生组,血清LDH水平高于未发生组(P<0.05);aEEG评分与出生后5 min Apgar评分、NBNA评分呈正相关,而与脑损伤严重程度呈负相关,血清LDH水平与之相反(P<0.05);妊娠期高血压疾病、妊娠期糖尿病、血清LDH水平为脑损伤发生的独立危险因素,产前使用糖皮质激素、aEEG评分为脑损伤发生的独立保护因素(P<0.05);出生后12 h aEEG评分、血清LDH水平联合检测评估脑损伤发生的AUC大于单项指标评估(P<0.05)。结论:aEEG评分、血清LDH水平与早产儿脑损伤严重程度密切相关,联合检测对脑损伤发生具有一定评估价值。

Objective:To explore the correlation between amplitude integrated electroencephalogram(aEEG)scores,serum lactate dehydrogenase(LDH)levels,and the severity of brain injury in premature infants,and to analyze their evaluation value in the occurrence of brain injury.Methods:A total of 212 preterm infants born in Luohe Central Hospital from January 2021 to June 2023 were retrospectively selected as the study subjects,and were divided into the occurrence group(86 cases)and non-occurrence group(126 cases)according to whether or not brain injury occurred after birth.aEEG score,serum LDH level,Apgar score 5 min after birth and neonatal neurological score(NBNA)were compared between the two groups.According to the severity of brain injury,27 cases were divided into mild,38 cases were moderate and 21 cases were severe.The aEEG scores and serum LDH levels were compared.The correlation of aEEG score,serum LDH level with the severity of brain injury,Apgar score 5 min after birth and NBNA score was analyzed.The influencing factors of brain injury were analyzed.To evaluate the value of aEEG score and serum LDH level in brain injury.Results:The aEEG score,Apgar score 5 min after birth and NBNA score in the occurrence group were lower than those in the non-occurrence group,and the serum LDH level was higher than that in the non-occurrence group(P<0.05).aEEG score was positively correlated with Apgar score and NBNA score 5 min after birth,but negatively correlated with the severity of brain injury,and the serum LDH level was opposite(P<0.05).Gestational hypertension,gestational diabetes and serum LDH level were independent risk factors for brain injury,while prenatal glucocorticoid use and aEEG score were independent protective factors(P<0.05).The AUC of 12 h postnatal brain injury was higher than that of single index by aEEG score and serum LDH level(P<0.05).Conclusion:The aEEG score and serum LDH level are closely related to the severity of brain injury in premature infants,and combined detection has certain evaluation value for the occurrence of brain injury.