摘要
目的探讨脑损伤新生儿在不同日龄时的超敏C反应蛋白(hs-CRP)和降钙素原水平及其临床意义。方法纳入56例足月脑损伤新生儿,均给予常规治疗。于产后3d(治疗前)、7d和28d,检测其血浆hs-CRP和降钙素原水平,并于生后3d进行新生儿行为神经评估(NBNA),于出生后7个月行神经发育Gesell评分。分析hs-CRP和降钙素原水平与NBNA评分、Gesell评分的相关性。采用受试者工作特征曲线分析不同日龄血浆hs-CRP和降钙素原水平预测脑损伤新生儿神经功能预后的价值。结果与生后3d比较,生后7d和28d的血浆hs-CRP和降钙素原水平降低,NBNA评分升高(均P<0.05)。Gesell评分<85分患儿在不同日龄时的血浆hs-CRP和降钙素原水平均高于Gesell评分≥85分患儿(均P<0.05)。NBNA评分<35分患儿在不同日龄时的血浆hs-CRP和降钙素原水平均高于NBNA评分≥35分患儿(均P<0.05)。血浆hs-CRP和降钙素原水平与Gesell评分、生后3d的NBNA评分均呈负相关(均P<0.05)。不同日龄的血浆hs-CRP和降钙素原水平单独或联合预测脑损伤新生儿神经功能预后的效能均较高,其中以生后28d的血浆hs-CRP和降钙素原水平联合预测的效能最高。结论脑损伤新生儿生后3d血浆hs-CRP和降钙素原水平明显升高,随着治疗时间的延长可逐渐降低。监测不同日龄时的hs-CRP和降钙素原水平有利于评估脑损伤新生儿的近远期神经功能发育情况。
Objective To investigate the levels and clinical significance of high-sensitivity C-reactive protein(hs-CRP) and procalcitonin at different days of age in neonates with brain injury. Methods Fifty-six full-term neonates with brain injury were enrolled,and received the routine therapy.On day 3(before treatment),day 7 and day 28 postpartum,their plasma hs-CRP and procalcitonin levels were detected,and the neonatal behavioral neurological assessment(NBNA) was conducted on day 3 postpartum,and Gesell score for neurological development was assessed at 7 months after birth. The correlation of hs-CRP and procalcitonin levels with NBNA score or Gesell score was analyzed.Receiver operating characteristic curve was used to assess the predictive value of plasma hs-CRP and procalcitonin levels at different days of age for prognosis of neurological function in neonates with brain injury. Results Compared with the levels on day 3 after birth,lower plasma hs-CRP and procalcitonin levels and higher NBNA score were observed on day 7 and day 28 after birth(all P <0.05).For neonates at different days of age,those with Gesell score<85 points had higher plasma hs-CRP and procalcitonin levels than those with Gesell score≥85 points(all P <0.05).For neonates at different days of age,those with NBNA score <35 points had higher plasma hs-CRP and procalcitonin levels than those with NBNA score ≥35 points(all P <0.05).Plasma hs-CRP and procalcitonin levels negatively correlated with Gesell score and postpartum 3-day NBNA score(all P <0.05).Plasma hs-CRP level,procalcitonin level,or their combination of neonates at different days of age reported relatively higher predictive efficiency for prognosis of neurological function in neonates with brain injury,and the optimal predictive efficiency was found in the combination of plasma hs-CRP and procalcitonin levels on day 28 after birth. Conclusion In neonates with brain injury,plasma hs-CRP and procalcitonin levels increase significantly on day 3 after birth,and might decrease gradually with the extension of therapeutic time. Monitoring hs-CRP and procalcitonin levels at different days of age is beneficial to assessing short or long-term neurological development in neonates with brain injury.
作者
刘其爱
朱文娟
莫炜明
杨建彬
LIU Qi-ai;ZHU Wen-juan;MO Wei-ming;YANG Jian-bin(Department of Laboratory Medicine,Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin 541002,China;Department of Neonatology,Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin 541002,China)
出处
《广西医学》
CAS
2019年第11期1360-1364,共5页
Guangxi Medical Journal
基金
广西医药卫生科研课题(Z2016259)
关键词
脑损伤
新生儿
日龄
超敏C反应蛋白
降钙素原
神经功能
预后
Brain injury
Neonate
Days of age
High-sensitivity C-reactive protein
Procalcitonin
Neurological function
Prognosis
作者简介
刘其爱(1971~),男,本科,副主任技师,研究方向:生化和临床检验。
