| ObjectiveTo investigate the correlation between serum S100 B protein levels and a EEG changes and the severity of bilirubin brain injury in neonates with full-term hyperbilirubinemia,amplitude integrated electroencephalography(a EEG)monitoring was performed and serum S100 B protein levels were detected.Follow-up observation and analysis of children at high risk of bilirubinemia brain injury with 6-month mental Screening Test(DST),to explore the value of serum S100 B protein level and a EEG changes in the long-term prognosis of hyperbilirubinemia brain injury,to provide objective basis for clinical judgment and effective intervention treatment.MethodsA total of 144 full-term neonates with hyperbilirubinemia admitted to the N eonatal Intensive Care Unit(NICU)of Taizhou People Hospital from January 2019 to December 2019 were randomly selected as the observation group(76 male s and 68 females;74 cases of natural delivery and 70 cases of cesarean delivery).The observation group was divided into mild hyperbile group(221μmol/L≤TSB<257μmol/L),moderate high bile(257μmol/L≤TSB<342μmol/L),severe high bile bilegroup(TSB≥342μmol/L).A total of 48 full-term neonates were randomly selecte d as the control group(21 males,27 females;24 cases of natural delivery and 24 cases of cesarean delivery).Blood samples of all enrolled children were collecte d within 24 h after admission.Serum S100 B protein level was detected by ELIS A,serum TSB level was measured by diazo method,and a EEG was monitored within 6h after admission.DST intelligent Development test was performed at 6months postpartum.SPSS 20.0 was used to statistically analyze the differences b etween different groups and the correlation between S100 B protein level,abnorm al degree of a EEG,Development Quotient(DQ),Mental Index(MI)and the sev erity of brain injury P<0.05 was considered statistically significant.Results1.A total of 144 children in the observation group and 48 children in the control group were included.There was no statistical significance in gender,day age,gestational age,birth weight and delivery mode between the observation group and the control group(P > 0.05).2.The concentrations of TSB in the control group and the observation group were61.72± 12.11μmol /L and 311.22±75.46μmol/L,respectively,and there was statistically significant difference between the two groups(t=-38.23,P<0.001),S100 B levels were826.23±400.91μmol/L and 1525.39±755.09μmol/L,respectively,and the difference between the two groups was statistically significant(t=-8.18,P<0.001),48 cases of normal a EEG in the control group,0 cases of mild a EEG,0 cases of severe a EEG in the control group,82 cases of normal a EEG,49 cases of mild a EEG,13 cases of severe a EEG in the observation group,the difference between the two groups was statistically significant(Z=-5.38,P<0.001).Compared with the control group,there were statistically significant differences in TSB,S100 B protein concentrations and a EEG abnormality(P<0.05).3.According to the TSB level,the observation group was divided into mild group,moderate group and severe group.The TSB concentration of mild group was 244.49±11.21μmol/L,the TSB concentration of moderate group was 290.03±10.59μmol/L,and the TSB concentration of severe group was 404.89±59.44μmol/L.0.001).The level of S100 B in mild group was 1196.83±436.13μmol/L,moderat e group was 1276.49±599.62μmol/L,and severe group was 2140.52±808.48μmol/L.The difference of S100 B protein levels among the three groups was statistical ly significant(F=42.86,P<0.001).In the mild group,there were 41 normal cases,8 mild cases,and 0 severe cases.In the moderate group,there were 32 normal cases,14 mild cases,and 3 severe cases.In the severe group,there were 9 nor mal cases,27 mild cases,and 10 severe cases,with statistical significance(H=75.50 P<0.001).4.The protein levels of TSB and S100 B in the observation group(r = 0.571,P<0.001)and the degree of a EEG abnormality(r = 0.619,P<0.001)were positively correlated.5.A total of 144 children in the observation group were followed up at 6months of age,and 5 of them were lost to follow-up(all in the mild group).Ac cording to DQ and MI scores,they were divided into three groups: normal grou p,suspicious abnormal group and abnormal group.The concentration of TSB in normal group was 248.48±18.44μmol/L,suspicious abnormal group was 282.28±54.81μmol/L,and abnormal group was 373.78±70.25μmol/L.The difference of TS B concentration between the three groups was statistically significant(P<0.001).T he S100 B level of the normal group was 1116.13±155.06μmol/L,the S100 B con centration of the suspicious abnormal group was 1401.99±739.99μmol/L,the S100 B level of the abnormal group was 1892.08±831.44μmol/L,the difference was s tatistically significant(F=12.94,P<0.001).There were 26 normal cases,2 mild ca ses and 0 severe cases in the normal group,45 normal cases,10 mild cases and1 severe cases in the suspicious abnormal group,9 normal cases,35 mild cases and 11 severe cases in the abnormal group.The differences were statistically si gnificant(H=64.53,P<0.001).Conclusion1.Hyperbilirubinemia can lead to brain damage in newborns,and the severity of brain damage is related to bilirubin levels.2.The serum S100 B protein level of neonates with hyperbilirubinemia is positively correlated with the severity of brain injury,which is expected to be used as a serological index for the assessment of the severity of brain injury.3.Serum S100 B protein level and a EEG can predict the neurological(intelligence,hearing,speech)prognosis of neonatal hyperbilirubinemia at an early stage,and can be used to evaluate the severity of brain function and long-term prognosis. |
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