The The Early Application Of AEEG And Biochemical Markers In Brain Injury In Premature Infants

PartⅠ The early application value of Amplitude integration ofelectroencephalogram (aEEG) in brain injury in prematureinfantsObjectAnalyse the the characteristics of aEEG in the preterm infants with brain injury,inorder to explore the aEEG application value in the premature infant with brain injuryand the significance in routine care of preterm infants.MethodsSelect the premature infants (gestational age <37weeks) of our hospital fromFebruary2013to December2013as the research object, which were divided into braininjury group and no brain damage according to the late head ultrasound and MRIresults.Two groups of preterm infants were received aEEG test in24h3d,7d afterbirth, at least3hours.Results1. The rates of abnormal aEEG background activities in brain injury group within24hours,3d,7d after birth were respectively60.00%,65.72%,68.57%.The rates ofnormal group were respectively28.92%,25.30%,21.69%, by the chi-square test, χ2were respectively10.083,17.194,23.606, P＜0.005, the discrepancy had statisticalsignificance.2. The rates of abnormal aEEG SWC in brain injury group within24hours,3day,7day after birth were respectively24.10%,25.30%and18.07%.The rates of normalgroup were respectively24.10%,25.30%and18.07%, by the chi-square test, χ2were respectively16.134,12.929,18.013, P＜0.005, the discrepancy had statisticalsignificance.3. The rates of abnormal aEEG SA in brain injury group within24hour,3day,7day after birth were respectively20.00%,25.71%,25.71%.The rates of normal groupwere respectively3.61%,4.82%and4.82%, by the chi-square test, χ2were8.522,10.964,10.964respectively, P＜0.005, the discrepancy had statistical significance.4. The abnormal aEEG results rate of two groups within24h,3day,7day afterbirth, abnormal brain injury group were65.71%,74.29%,77.14%, no brain injurygroup were28.92%,25.30%and21.69%respectively. By chi-square test, χ2were13.910,24.648,32.092, P＜0.005, the discrepancy had statistical significance.ConclusionThe rate of abnormal aEEG in brain injury group in preterm infants was higherthan normal preterm infants, indicating that aEEG can be used for early detection ofbrain injury in preterm infants. The occurrence rate of DNV,SWC and SA was higherthan normal preterm infants.PartⅡ The the early diagnostic value of serum NSE, IL-6,S100B protein and aEEG in brain injury in premature infantsObjectTo understand the relationship between brain injury and serum NSE, IL-6, S100Bprotein levels in preterm infants, and early diagnosis value of serum NSE, IL-6,S100B protein and aEEG for premature infant with brain injury.MethodsThe experimental subjects and grouping method were same with the part one. Twogroups of preterm infants’ venous blood was collected1d,3d,7d after birth. Based onthis, the serum levels of NSE, IL-6, S100B protein were compared between the twogroups.The aEEG monitoring was same with part one. ResultsThe levels of NSE、 IL-6and S100B protein in brain injury group weresignificantly higher than those in control group(P<0.05), the ROC curves of serumNSE, IL-6, S100B protein showed that the areas under the curve were0.904、0.851、0.9201day after birth,0.921、0.864、0.8983day after birth,and0.859、0.836、0.8727day after birth,which had statistical significance.The accuracy of aEEG for diagnosisof brain injury were69.49%,74.58%,77.97%.ConclusionDynamic monitoring the levels of serum NSE, IL-6, S100B protein have theimportant significance for the early diagnosis of preterm brain injury. Serum NSE, IL-6, S100B protein and aEEG in premature brain injury have high diagnostic value, theiradvantages can apply in preterm infants early detection of brain damage.