新生儿缺氧缺血性脑病中血清尿酸及新生儿行为神经测定的相关性研究

目的观察新生儿缺氧缺血性脑病(HIE)患儿血清尿酸(UA)、新生儿行为神经测定(NBNA)的变化及其相关性,探讨其临床意义。方法采用新Beckman CX9生化分析仪检测29例(轻度10例,中度10例,重度9例)新生儿HIE急性期及其中16例处于恢复期的患儿血清尿酸值及NBNA评分,并与20名健康新生儿作为对照。结果新生儿HIE患儿轻度、中度与重度期血清尿酸水平逐渐升高,急性期与恢复期比较差异有统计学意义(P<0.05),新生儿HIE恢复期血清尿酸水平下降,与健康对照组比较差异有统计学意义(P<0.05),新生儿HIE患儿组NBNA较健康对照组明显降低,各组之间的NBNA分值比较差异有统计学意义(P<0.05),HIE患儿急性期与恢复期血清尿酸与NBNA评分均呈负相关。结论血清尿酸及NBNA与新生儿HIE的临床分度密切相关,临床分度越重,血清尿酸值越高,NBNA评分越低,随着病情恢复,血清尿酸值逐渐下降,NBNA评分逐渐升高。血清尿酸结合NBNA评分可作为新生儿HIE早期判断及预后估计的指标。

The association of serum uric acid in neonatal hypoxic-ischemic encephalopathy and neonatal behavioral neurological assemment

Objective To observe the changes and association of serum uric acid（UA）,neonatal behavioral neurological assessment（NBNA） in newborns with neonatal hypoxicischemic encephalopathy（HIE）,and to discuss its clinical significance.Methods Beckman CX9 automatic biochemical analyzer was used to detect the serum UA values and NBNA scores of 29 HIE newborns（mild：n=10;moderate：n=10;severe：n=9） in acute period and notably 16 cases in recovery period,with 20 normal newborns assigned as controls.Results The serum UA level was gradually increased in HIE newborns of mild,moderate and severe periods,and difference was found between severe period and recovery period（P〈0.05）.The serum UA level was decreased in HIE newborns of recovery period,who was different from the normal controls（P〈0.05）.As compared with control group,the HIE groups had significantly lowered NBNA scores.The NBNA scores were found different among different groups（P〈0.05）.The serum UA was negatively correlated with NBNA scores in HIE newborns of both acute and recovery periods.Conclusion The serum UA and the NBNA were closely correlated with the clinical grading of neonatal HIE.Furthermore,as the clinical grading became higher,the serum UA values were found higher and the NBNA scores lower.Along with the recovery of disease,the serum UA values were gradually decreased and NBNA scores increased.The serum UA combined with NBNA scoring could be used as the indicator of early diagnosis and prognosis assessment of neonatal HIE.