早期综合干预对缺氧缺血性脑病新生儿神经行为发育及血清SIOOB水平的影响

目的探讨早期综合干预对新生儿缺氧缺血性脑病（HIE）神经行为的影响及与血清S100B蛋白的关系。方法将120例HIE患儿随机分为对照组和干预组，干预组在药物治疗的基础上，给予各种感知觉刺激、视听刺激、主动及被动肢体训练等早期综合干预，对照组只给予药物治疗。采用婴幼儿智力发育量表删智力发育指数（mental developmental index，MDI）和运动发育指数（psychomotor developmental index，PDI）分别在于预后3，6，12，18个月进行测定。采用酶联免疫法检测S100B蛋白水平。结果干预组HIE患儿MDI评分从12个月开始，明显高于对照组，差异有显著性12个月：干预组（96．6±9．4）分，对照组（86．8±9．5）分，P〈0．01]。于预组HIE患儿PDI评分从6个月开始，明显高于对照组，差异有显著性6个月：干预组（91．6±9．2）分，对照组（82．2±11．0）分，P〈0．01]。两组HIE患儿随着月龄的增长．血清S100B蛋白的水平有下降的趋势。在出生后两组患儿血清S100B蛋白水平较高，且没有差异（P〉0．05）；从3个月开始，干预组患儿的血清S100B蛋白水平降低较明显，与对照组比较，各时间点的水平差异有显著性3个月：干预组（1．29±0．15）ng/L，对照组（1．40±0．14）ng／L；6个月：干预组（1．06±0．21）ng／L，对照组（1．26±0．22）ng／L，P〈0．05，P〈0．01]。结论早期综合干预能够改善HIE患儿的智力和运动发育，血清S100B蛋白是可能的机制之一。

Effect of early comprehensive intervention on neuro-behavior development and serum SIOOB of neonates with hypoxic-ischemic encephalopathy

Objective To investigate the early comprehensive intervention on neonatal hypoxic ischemic encephalopathy （HIE） effects and the biological mechanisms. Methods 120 cases of HIE were randomly divided into intervention group and control group. Under the basis of drug treatment, the intervention group were given the different perceptual stimuli ,audiovisual stimulation, active and passive limb training early comprehensive intervention,the control group only to normal drug treatment. The mental development index （MDI） and psychomotor develo pmental index （PDI） were applied after 3,6,12,and 18 months. SIOOB protein levels were detected using enzyme immunoassay. Results MDI score in the intervention group with HIE, from the beginning of the 12 month,was higher than that in the control group,there was significant differences （12th month： （96.6 ±9.4） vs （ 86.8 ± 9.5 ） , P 〈 0.01 ）. PDI score from the beginning of the 6 month, was higher in the intervention group with HIE than that in the control group,there were significant differences （6th month： （91.6 ±9.2） vs （82.2 ± 11.0）, P〈0.01 ）. Serum S100B protein level has a tendency to fall for all HIE patients with the old growth. Born in two groups of serum S100B protein levels were higher in neonate period,but there was no difference （P〉 0.05 ）. From the beginning of the 3rd month,serum S100B protein levels in the intervention group were reduced significantly,compared with the control group at each time point level （3rd month： （1.29 ±0. 15 ）ng/L vs （1.40 ± 0.14）ng/L;6th month：（1.06 ±0.21）ng/L vs （1.26 ±0.22）ng/L, P〈0.01）. Conclusion Early intervention can improve the mental and motor development of children with HIE,and serum S100B protein is involved in the mechanisms.