目的 分析振幅整合脑电图(aEEG)联合血清神经元特异性烯醇化酶(NSE)、S100-β蛋白水平对早产儿脑损伤的诊断价值,为早期判断早产儿脑损伤提供临床依据。方法 选取2016年5月-2018年5月新乡市中心医院新生儿病房存在脑损伤高危因素的98例早产儿为研究对象,根据《早产儿脑损伤诊断与防治专家共识》中诊断标准分为脑损伤组56例,非脑损伤组42例。所有新生儿均进行aEEG检查和血清NSE、S100-β蛋白检测。分析并比较aEEG、血清NSE、S100-β单一检测和联合检测诊断早产儿脑损伤的灵敏度、特异度和准确率,绘制ROC曲线并记录曲线下面积(AUC值)。结果 aEEG、血清NSE、S100-β单一检测和联合检测诊断早产儿脑损伤的灵敏度分别为82.14%、71.43%、69.64%、94.64%,特异度分别为66.67%、80.95%、76.19%、61.90%,准确率分别为75.51%、75.51%、72.45%、80.61%,AUC值分别为0.744、0.762、0.729、0.783,联合检测可显著提高灵敏度(P＜0.05)。结论 aEEG、血清NSE、S100-β均可作为早产儿脑损伤的诊断指标,且三者联合检测可明显提高诊断效能。

Objective To analyze the diagnostic value of amplitude-integrated electroencephalogram (aEEG) combined with serum neuron-specific enolase (NSE) and S100-β protein levels in the diagnosis of cerebral injury in premature infants, so as to provide clinical basis for the early diagnosis. Methods A total of 98 premature infants with high-risk factors for cerebral injury in neonatal wards of Xinxiang Central Hospital from May 2016 to May 2018 were selected as participants in this study.According to the diagnostic criteria in Expert Consensus for Diagnosis and Prevention of Brain Injury in Premature Infants, the premature infants were divided into cerebral injury group (n=56) and non-cerebral injury group (n=42).And aEEG was performed in all neonates, and serum levels of NSE and S100-β protein were tested.The sensitivity, specificity, and accuracy of single indicator detection and combined detection of aEEG, serum NSE and S100-β in the diagnosis of premature infants with cerebral injury were analyzed and compared.Then the receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC value) was recorded. Results The sensitivity values of single indicator detection and combined detection of aEEG, serum NSE and S100-β in the diagnosis of premature infants with cerebral injury were 82.14%, 71.43%, 69.64%, and 94.64%, respectively; The specificity values were 66.67%, 80.95%, 76.19%, and 61.90%, respectively; The accuracy rates were 75.51%, 75.51%, 72.45%, and 80.61%, respectively, and the AUC values were 0.744, 0.762, 0.729 and 0.783, respectively.It was indicated that the combined detection could significantly improve the sensitivity (P<0.05). Conclusion aEEG, serum NSE and S100-β can be used as diagnostic indicators for premature infants with cerebral injury, and combined detection of the three indexes can significantly improve the diagnostic efficacy.