【作者】 秦飞；

【导师】 张小莉；

【作者基本信息】 山西医科大学 ， 儿科学， 2008， 硕士

【摘要】 目的:探讨新生儿缺氧缺血性脑病(HIE)患儿血清S100B水平与脑实质CT值的变化及两者之间的相关性。为临床早期诊断及评价新生儿脑损伤程度,探索HIE发病机制提供客观的依据。方法:对30例HIE患儿与10例无出生窒息对照足月儿采用酶联免疫吸附试验(ELISA)测定血清S100B水平;采用西门子欢星型螺旋CT扫描机进行头颅CT平扫,测定脑实质CT值;同时收集临床资料。结果:①在急性期轻度HIE组血清S100B值为0.86±0.24μg/L,中重度HIE组血清S100B值为1.78±0.33μg/L,对照组血清S100B值为0.44±0.23μg/L。三组数据间有显著统计学意义(P＜0.01)。②中重度HIE组血清S100B值在急性期明显高于轻度HIE组,差异有显著统计学意义(P＜0.01)。轻度HIE组血清S100B值在急性期明显高于对照组,差异具有显著统计学意义(P＜0.01)。③中重度HIE患儿血清中S100B值由急性期的1.78±0.33μg/L下降至恢复期的0.68±0.32μg/L,差异有显著统计学意义(P＜0.01)。轻度HIE组急性期血清S100B值由急性期的0.86±0.24μg/L,下降至恢复期时0.47±0.11μg/L,差异有显著统计学意义(P＜0.01)。④S100B与CT值的关系急性期HIE组血清S100B与CT值呈负相关关系,相关系数为-0.662(r=-0.662,P＜0.01)。结论:①HIE患儿血清S100B浓度较非HIE患儿明显升高,说明S100B参与新生儿缺氧缺血性脑病的病理生理过程。②HIE患儿血清S100B水平变化与病情轻重及病程有密切关系,提示动态监测S100B水平变化对临床早期判断HIE患儿病情轻重程度及指导治疗有重要意义。③急性期HIE组血清S100B与CT值呈负相关关系,HIE组S100B与CT值二者结合有利于更准确地评估HIE病情。更多还原

【Abstract】 Objective:To investigate the change of serum S100B and brain CT value in patients with HIE,as well as the variations of them.It can be used to provide the evidence in early diagnosis,evaluate the degree of brain damage and guild treatment of HIE.Methods:We detected the level of serum S100B by ELISA in 30 HIE patients and 10 control full-term infants,CT values of all the patients were obtained with huanxing Simens type of CT meanwhile,collected the clinical information completely.Results:①The serum level of S100B in control group was 0.44±0.23μg/L.The level of S100B in mild HIE group was 0.86±0.24μg/L whereas that of moderate-severe HIE group was 1.78±0.33μg/L in the acute period.There was significant difference among them(P＜0.01).②There was significant difference of S100B concentration between the mild HIE group and the control group during the acute period(P＜0.01).There was significant difference of S100B concentration between mild HIE group and moderate-severe HIE group during the acute period (P＜0.01).③The serum level of S100B in moderate-severe HIE group in acute period was 1.78±0.33μg/L,which dropped to 0.68±0.32μg/L in recovery period.There was significant difference between them(P＜0.01).The serum level of S100B of mild HIE group in acute period was0.86±0.24μg/L,which declined to 0.47±0.11μg/L in recovery period.There was significant difference between them(P＜0.01).④The brain CT values of the moderate and severe HIE group were lower than the mild group.With correlation analysis,negative corre- lations were founded between serum S100B and brain CT values.The correlation coefficient was -0.662.Conclusion:①The serum level of S100B in HIE patients are higher obviously than non-HIE groups,which shows that it participates in the path physiological process of neonate hypoxic-ischemic encephalopathy.②There are close relationships between the change of S100B and the patient’s condition,course of disease.It is significant to supervise the trends of S100B for judging the state of disease and directing treatment in early stage of HIE.③There are negative correlation between S100B and CT scan value,they both are useful for judging the state of disease.更多还原