本文選題：早產(chǎn)兒腦損傷 + 神經(jīng)元特異性烯醇化酶�。� 參考：《蚌埠醫(yī)學院》2017年碩士論文

【摘要】：目的本研究旨在以頭顱MRI結果為標準,探討早產(chǎn)兒腦損傷(brain injury in premature infants,BIPI)與生后24小時內(nèi)血清神經(jīng)元烯醇化酶(neuron specific enolase,NSE)水平的關系,及NSE對BIPI的預測價值;并分析影響B(tài)IPI患者生后24小時內(nèi)血清NSE水平的因素,如胎齡、出生體重、分娩方式、單胎、多胎、Apgar評分、妊娠期高血壓疾病(hypertensive disorders in pregnancy,HDP)、合并新生兒呼吸窘迫綜合征(neonatal respiratory distress syndrome,NRDS)等。為BIPI病情早期預測及評估提供臨床依據(jù)。方法選取2016年1月至5月期間我院出生并住院的早產(chǎn)兒,均在生后24h內(nèi)采血查血清NSE水平,同時完善常規(guī)化驗及體格檢查。均由統(tǒng)一培訓合格的醫(yī)護人員現(xiàn)場收集所有研究對象的基本信息及病例資料。結合臨床癥狀、頭顱MRI結果分為腦損傷組82例、非腦損傷組96例,對比兩組血清NSE水平,并具體分析影響血清NSE水平的因素。結果(1)根據(jù)頭顱MRI結果,比較兩組生后24小時內(nèi)早產(chǎn)兒血清NSE的檢測結果,腦損傷組較無腦損傷組有所升高,差異有統(tǒng)計學意義(t=2.48,P㩳0.05)。(2)腦損傷組分娩方式、單胎與多胎間與血清NSE水平差異不明顯,無統(tǒng)計學意義(P㧐0.05);(3)腦損傷組不同胎齡、出生體重間血清NSE水平差異有統(tǒng)計學意義(P㩳0.05)。(4)采用Pearson相關分析對腦損傷組胎齡、出生體重、母親年齡進行相關性分析:胎齡與早產(chǎn)兒血清NSE水平存在良好的相關性,呈負相關,γ=-0.29,P=0.01;出生體重與早產(chǎn)兒血清NSE水平存在良好的相關性,呈負相關,γ=-0.47,P=0.00;母親年齡與早產(chǎn)兒血清NSE水平無明顯相關性,γ=0.07,P=0.98。(5)腦損傷組胎盤異常、臍帶異常、羊水異常與血清NSE水平差異無統(tǒng)計學意義(P㧐0.05);HDP、胎膜早破、NSRD影響血清NSE水平(P㩳0.05)。(6)腦損傷組血清NSE的水平與胎齡、出生體重、胎膜早破、HDP、新生兒呼吸窘迫綜合征存在線性回歸關系,其中與出生體重呈負相關。由標準化系數(shù)看出生體重對血清NSE水平影響最大。結論1.BIPI生后24小時內(nèi)血清NSE增高,說明生后早期檢測NSE可以成為診斷BIPI的生物標志物。2.患兒的胎齡、出生體重、胎膜早破、HDP、NRDS為影響血清NSE水平的因素。3.早產(chǎn)兒的胎齡、出生體重、胎膜早破、HDP、NRDS與血清NSE水平存在線性回歸關系,其中出生體重對血清NSE水平影響最大。
[Abstract]:Objective to investigate the relationship between (brain injury in premature infantile and serum neuron enolase (neuron specific Enolase) levels within 24 hours after birth, and to evaluate the predictive value of (brain injury in premature in preterm infants. The factors influencing serum NSE levels within 24 hours after birth were analyzed, such as gestational age, birth weight, mode of delivery, single fetus, multiple fetal Apgar score, (hypertensive disorders in presupposition of hypertensive disorder complicating pregnancy (hypertensive disorders in) and neonatal respiratory distress syndrome (neonatal respiratory distress syndromesia). To provide clinical basis for early prediction and evaluation of BIPI. Methods Serum NSE levels of premature infants born and hospitalized in our hospital from January to May 2016 were collected within 24 hours after birth, and routine laboratory tests and physical examination were completed at the same time. The basic information and case data of all the subjects were collected by trained qualified medical staff in the field. According to the clinical symptoms, the cranial MRI results were divided into brain injury group (n = 82) and non-brain injury group (n = 96). The serum NSE levels were compared between the two groups, and the factors affecting the serum NSE levels were analyzed. Results (1) according to the results of cranial MRI, the results of serum NSE in preterm infants within 24 hours after birth in the two groups were compared. The level of serum NSE in the brain injury group was higher than that in the non-brain injury group, and the difference was statistically significant (t = 2.48) P ~ (0.05). (_ 2) the delivery mode of the brain injury group was higher than that of the non-brain injury group. There was no significant difference in serum NSE levels between single and multiple births. There was no statistical significance (P0. 05); (3). There were significant differences in serum NSE levels between birth weight and brain injury group (P0. 05). (4). The gestational age and birth weight of brain injury group were analyzed by Pearson correlation analysis. There was a good correlation between gestational age and serum NSE level of premature infants, and there was a good correlation between birth weight and serum NSE level of premature infants, and there was a negative correlation between gestational age and serum NSE level of preterm infants, 緯 -0.29 P < 0.01, and a good correlation between birth weight and serum NSE level of premature infants. There was no significant correlation between maternal age and serum NSE level of premature infants. (5) placenta and umbilical cord were abnormal in brain injury group. There was no significant difference between amniotic fluid abnormalities and serum NSE levels (P0. 05). There was a linear regression relationship between serum NSE levels and fetal age, birth weight, premature rupture of membranes and neonatal respiratory distress syndrome in brain injury group. There was a negative correlation between birth weight and birth weight. The influence of birth weight on serum NSE level was the greatest in terms of standardized coefficient. Conclusion 1. Serum NSE increased within 24 hours after birth, indicating that early postnatal detection of NSE can be used as a biomarker for the diagnosis of BIPI. 2. Gestational age, birth weight and HDP- NRDS were the factors affecting serum NSE level. There was a linear regression relationship between fetal age, birth weight, premature rupture of membranes and serum NSE level, in which birth weight had the greatest influence on serum NSE level.
【學位授予單位】：蚌埠醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R722.6

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