回顾性分析43例足月窒息新生儿脑血流动力学与血清神经元特异性烯醇化酶（S-NSE）动态变化的临床意义

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Abstract Objective: To investigate the clinical significance of dynamic changes of cerebral hemodynamics and serum neuron specific enolase(S-NSE) in full term neonates with asphyxia. Methods: Color Doppler ultrasound was applied to monitor the changes of peak systolic velocity(PSV), end diastolic velocity(EDV) and resistance index(RI) of the middle cerebral artery(MCA) at the 1, 3 and 7 days in 43 cases of asphyxiated full term neonates(asphyxia group) and 10 cases of full-term normal neonates(control group). Moreover, the serum NSE at the 1, 3 and 7 days in the asphyxia group and the 1 day in the control group were available. In strict accordance to the neonatal hypoxic ischemic encephalopathy(HIE) clinical diagnosis and grading standard made in 2000 by the neonatal study group of Chinese Medical Association, the newborns in the asphyxia group were divided into non-HIE group, mild HIE group, moderate HIE group and severe HIE group. Retrospective analysis was performed on cerebral hemodynamic parameters and S-NSE values between each group. Results: Compared with the control group, the asphyxia group showed decreased PSV and EDV, and increased RI with the deterioration of HIE degrees. After treatment, the three parameters became bettered when HIE was less severe, the recovery was more rapid. S-NSE value increased significantly with deterioration of HIE degrees. After treatment, S-NSE value gradually decreased when HIE was less severe, the decrease was more rapid. The areas under the curve(AUC) of RI and S-NSE were 0.768 and 0.874. The sensitivity was 58.1% and 73.5%, and the specificity was 93.6% and 90.5%, respectively. RI and S-NSE showed low positive correlation with a correlation coefficient of 0.354. Conclusion: Dynamic detection of neonatal cerebral hemodynamics and S-NSE value is important for early diagnosis, grading and prognosis estimation of HIE. This combination can improve the accuracy of HIE diagnosis.

Key words： Asphyxia, neonatorum Phosphopyruvate hydratase Ultrasonography, Doppler, color

Received: 21 October 2016

PACS:	Ｒ722.12
	Ｒ445.1

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	WANG Shi-jie
	LI Cao
	LI Ming-xing

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WANG Shi-jie,LI Cao,LI Ming-xing. Retrospective analysis of clinical significance of dynamic changes of cerebral hemodynamics and#br# S-NSE in full term neonates with asphyxia[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(7): 466-470.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2017/V28/I7/466

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