HIE大脑中动脉血流动力学变化与血清S100B水平的相关性研究

目的 探讨足月新生儿缺氧缺血性脑病(HIE)大脑中动脉变化与血清S100B水平的相关性研究。方法选取本院85例生后24 h即收入院的足月新生儿HIE患者为研究对象,另选30例正常足月新生儿为对照组。应用SIEMENS ACUSON X300彩色超声多普勒诊断仪及ELISA法测定两组脑血流参数及血清S100B水平。结果对照组新生儿脑实质回声均匀,脑室系统无扩张或狭窄,且随出生时间延长新生儿侧脑室前角面积、收缩期峰值流速(Vs)、舒张末期流速(Vd)不断增大,而HIE患儿侧脑室前角面积、Vs、Vd随着出生时间延长而增加,但增加幅度小于对照组,且病情越重增加幅度越小。HIE血清S100B浓度逐日下降,HIE轻度组于生后第120 h接近对照组水平,HIE中、重度组与对照组仍存在差异(P<0.05)。经Pearson相关分析可知,S100B与Vs、Vd呈负相关(P<0.05),与阻力指数(RI)、搏动指数(PI)呈正相关(P<0.05)。结论外周血S100B蛋白及脑血流动力学紊乱是HIE患儿脑损伤的重要原因,两者相互作用,相互影响。

The Correlation of the Levels of Full Serum S100B of Term Neonates with Hypoxic-ischemic Encephalopathy Brain Hemodynamic

Objective Objective To explore the correlation between changes in middle cerebral artery of the full-term neonates with hypoxic-ischemic encephalopathy (HIE) and the levels of serum S100B .Methods85 patients of full-term neonates with hypoxic ischemic encephalopathy 24 h after born were selected as the research object,the cerebral blood flow parameters and the serum levels of S100B in two groups were applicated with SIEMENS ACUSON X300 color Doppler diagnostic apparatus and ELISA.Another 30 normal infants were selected as control group.ResultsThe neonatal brain parenchyma of control group in echo uniform,with no expansion of the ventricular system or stenosis,and with prolonged time newborn ventricle horn area,peak systolic velocity (Vs),diastolic velocity (Vd) increased,and those of HIE children increased too,but the increase was less than the control group,and the more severe the disease the smaller the increase was. The serum S100B concentrations of HIE decreased day by day,mild HIE group approached the level of the control group 120 h after birth,and there were still differences (P<0.05) in the moderate or severe group and control group. By Pearson correlation analysis,S100B and Vs,Vd were negatively correlated (P<0.05),and the resistance index (RI) and pulsatility index (PI) were positively correlated (P<0.05).ConclusionsPeripheral blood S100B protein and cerebral hemodynamics dynamics disorder play important role in neonates with HIE brain injury,and the two influence each other.