脑血流量与S100β联合检测在新生儿早发型败血症相关性脑病早期诊断中的价值

The Value of Combined Detection of Cerebral Blood Flow and S100β in the Early Diagnosis of Neonatal Early-Onset Sepsis-Associated Encephalopathy

摘要: 目的：探讨血液炎症及脑损伤生物标志物与脑血流量变化联合检测在新生儿早发型败血症中败血症相关性脑(SAE)早期诊断中的价值。方法：选取我院收治的早发型败血症新生儿为研究对象，患儿入院1 h内，应用抗生素治疗前，检测血液炎症及脑损伤生物标志物水平，采用经颅超声检查其脑血流动力学的变化。采用ROC曲线评估血液炎症及脑损伤生物标志物与脑血流量变化单独检测及联合检测预测SAE的效能。结果：两组间胎龄、性别、出生体重无显著性差异(P > 0.05)；两组WBC、CRP、PCT、NSE及S100β水平、两组大脑前动脉(ACA)、大脑中动脉(MCA)的峰值收缩速度(PSV)、舒张末期速度(EDV)、搏动指数(PI)均有显著性差异(P < 0.05)。SAE组WBC、CRP、PCT、NSE及S100β水平ACA、MCA的PSV及EDV显著高于非SAE组，MCA的PI显著低于非SAE组(P < 0.05)。ROC曲线显示，MCA PI + S100β联合检测的AUC为0.957远高于各检测指标单独检测效能。结论：MCA PI + S100β联合检测对早期诊断SAE具有较高的临床诊断价值。

Abstract: Objective: Explore the value of the biomarkers of blood inflammation and brain damage and cerebral blood flow changes in early diagnosis of sepsis-associated encephalopathy (SAE). Methods: Select the newborns with premature sepsis from the seizure of the hospital as a research object. The child is within 1 h in the hospital. Before applying antibiotic treatment, the serum blood routine, CRP and PCT level are detected, and the changes in the cerebral blood mobility of the cerebral hemorrhage are used through the craniotomy. The ROC curve is used to evaluate the effectiveness of the blood conventional inflammation factor and the changes in cerebral blood flow, and the efficiency of the joint detection and prediction of SAE. Results: There are no significant differences in the age, gender, and birth weight between the two groups (P > 0.05); in the two groups, WBC, CRP, PCT, NSE and S100β levels, the peak shrinkage speed of the two sets of primary cerebral arteries (ACA) and the mid-cerebral artery (MCA), the peak shrinkage speed (PSV), the end of diastolic speed (EDV), and the fighting index (PI) all have significant differences (P < 0.05). The SAE group WBC, CRP, PCT, NSE and S100β levels ACA, MCA’s PSV and EDVs are significantly higher than the non-SAE group. The PI of MCA is significantly lower than the non-SAE group (P < 0.05). The ROC curve indicates that the combined detection of MCA PI + S100β has an AUC of 0.957, which is significantly higher than the diagnostic efficacy of each marker tested individually. Conclusion: The combined testing of MCA PI + S100β holds substantial clinical diagnostic value for the early diagnosis of SAE.