Clinical Study Of The Dynamic Monitoring Of Serum S-100B Protein Levels In Newborns With Hypoxic Ischemic Encephalopathy

Objectives:TO observation the regularity of dynamic changes serum protein levels in newborns with hypoxic ischemic encephalopathy(HIE). To investigate the clinical value of S-100B and NBNA scores on neonatal with hypoxic ischemic encephalopathy in early judgment and prognosis, and study the clinical significance of high risk factors in perinatal stage.Methods:The the serum S-100B protein linked immunosorbent assay (ELISA) Test Kit was used, using by double antibody sandwich method to determine serum S-100B values for 55 cases of children with HIE and 30 patients from the healthy term infants at the 1 day,2 days and 7 days after birth. The clinic data of two groups during pregnancy was recorded and the perinatal risk factors associated with HIE were analyzed. NBNA score for HIE children at the same time were evaluated, to determine the function of the nervous system and the estimated prognosis.Results:1. There was significantly different between HIE group with the control group (P <0.01).To compare serum S-100B protein at 1st and 2nd days after birth,there was still significantly different between HIE group of mild, moderate and severe levels with the control group (P<0.05).To compare serum S-100B protein at 7th days after birth,there was still significantly different between HIE group of moderate and severe levels with the control group (P<0.05),no significant differences were observed in the mild group as compared with the levels of control group at 7th days (P>0.05).To compare serum S-100B protein in newborns with HIE, there was still significantly different between the different pathogenetic condition at the same time (P<0.05); The serum S-100B protein is elevated at the 1st day after birth, the serum S-100B protein levels on the next day higher than the first day.The serum S-100B protein was significantly reduced on the 7th day, but still higher than the concentration control group.2. To compare NBNA score in newborns with HIE, there was still significantly different between the different pathogenetic condition at the same time (P<0.01); To compare NBNA score at 1st and 2nd days after birth,there was still significantly different between HIE group of mild, moderate and severe levels with the control group (P<0.05), and negatively correlated with the severity, the more severe the disease, the lower the score. To compare NBNA score in the same pathogenetic condition, there was still significantly different between the different time (P<0.01);The first day to seventh day after birth, NBNA score continues to grow. To compare NBNA score at 7th days after birth,there was still significantly different between mild group with the moderate group (P<0.05). The NBNA score of the mild, moderate and severe patients at 7th day (<35 points).accounted for 33.3%,47.1% and 100%.3. Most of the HIE patients have perinatal of risk factors.10 cases of umbilical cord around the neck of which,20 cases of meconium,6 cases of abnormal fetal position and twin,10 cases of pregnancy-induced hypertension syndrome,22 cases of premature rupture of membranes,placental abruption and placenta previa,Conclusions:1.serum S-100B protein for HIE children was significantly higher than that of normal newborns, and the more severe the disease, the higher S-100B protein levels, Confirmed the important role of S-100B protein that to early diagnosis of HIE and to determine pathogenetic condition; Dynamic observation of serum S-100B protein in the development of HIE, found that it has some regularity.2. Perinatal risk factors closely related with the occurrence of HIE.It is an important part of the process for the pathogenesis of HIE.3. Perinatal asphyxia can lead to HIE, the severe cases may occur cerebral palsy and nervous system hypoevolutismus after birth.3. NBNA score have the better value to judge the brain injury early, it is consistent with the degree of clinical HIE, the more severe the disease, the lower the score. NBNA score have the great value for the prognosis of children with HIE. Dynamic detection the NBNA score for children with HIE, Combined with serum S-100B protein at the same time, can judge the severity and changes of HIE, and can provide the basis to judge prognosis.