CAJ | 학술논문

目的探讨脑白质损伤( periventricular leukomalacia,PVL)患儿血清髓鞘碱性蛋白(myelin basic protein,MBP)及S100B蛋门(S100B protein,S100B)的动态变化及其与患儿预后的关系.方法对2007年11月至2008年7月我院住院的78例PVL早产儿(PVL组)和43例正常早产儿(正常对照组),分别在其生后第1、3、7、14天测定血清中MBP及S100B含量.30例正常早产儿及69例PVL患儿出院后每3个月随方1次,直至纠正胎龄至1岁,用Gesell发育量表测定其智力以及运动发育情况.结果 (1) PVL组患儿血清MBP于生后第1天升高[(7.61±1.78) μg/L]、第3天达峰值[( 14.53±3.12) μg/L],后随病情好转,逐渐降低；与正常对照组比较,PVL组患儿在生后第1、3、7、14天血清MBP水平均明显高于正常对照组(P＜0.05).(2) PVL组患儿血清S100B水平在生后第1、3、7天明显升高[(3.82±0.68),(4.41±0.91),(5.78±1.54) μg/L],第7天达峰值,与正常对照组比较,差异有统计学意义(P＜0.05)；至生后第14天时,S100B明显降低,两组比较已无明显差异(P＞0.05).(3) PVL组患儿生后第7天血清S100B、MBP持续升高者,随访至1岁时其发育商比生后第7天血清S100B及MBP明显下降者落后；也明显落后于正常早产儿(P＜0.05).结论 PVL患儿生后血清MBP及S100B水平与病情严重程度相关.如患儿血清MBP及S100B持续升高超过7d,则发育商明显落后,预后不良.
목적 탐토뇌백질손상( periventricular leukomalacia,PVL)환인혈청수초감성단백(myelin basic protein,MBP)급S100B단문(S100B protein,S100B)적동태변화급기여환인예후적관계.방법 대2007년11월지2008년7월아원주원적78례PVL조산인(PVL조)화43례정상조산인(정상대조조),분별재기생후제1、3、7、14천측정혈청중MBP급S100B함량.30례정상조산인급69례PVL환인출원후매3개월수방1차,직지규정태령지1세,용Gesell발육량표측정기지력이급운동발육정황.결과 (1) PVL조환인혈청MBP우생후제1천승고[(7.61±1.78) μg/L]、제3천체봉치[( 14.53±3.12) μg/L],후수병정호전,축점강저；여정상대조조비교,PVL조환인재생후제1、3、7、14천혈청MBP수평균명현고우정상대조조(P＜0.05).(2) PVL조환인혈청S100B수평재생후제1、3、7천명현승고[(3.82±0.68),(4.41±0.91),(5.78±1.54) μg/L],제7천체봉치,여정상대조조비교,차이유통계학의의(P＜0.05)；지생후제14천시,S100B명현강저,량조비교이무명현차이(P＞0.05).(3) PVL조환인생후제7천혈청S100B、MBP지속승고자,수방지1세시기발육상비생후제7천혈청S100B급MBP명현하강자락후；야명현락후우정상조산인(P＜0.05).결론 PVL환인생후혈청MBP급S100B수평여병정엄중정도상관.여환인혈청MBP급S100B지속승고초과7d,칙발육상명현락후,예후불량.
Objective To investigate the changes of serum myelin basic protein (MBP) and S100B orotein (S100B) in premature infants with periventricular leukomalacia (PVL) and their outcomes.Methods Seventy-eight premature infants with PVL (PVL group)and 43 normal infants (control group)who were hospitalized in our hospital from Nov 2007 to Jul 2008 were enrolled in the study.The infants were sampled for MBP and S100B levels on 1st,3rd,7th and 14th d after birth.Thirty normal infants and 69 infants with PVL were followed up every three months as they discharged until they were one year corrected age and their development quotients(DQ) were measured using Gesell development schedules.Results ( 1 ) The serum MBP levels increased on day 1 [ (7.61 ± 1.78 ) μg/L ],peak on day 3 [ ( 14.53 ± 3.12 ) μg/L],and then decreased.The serum MBP levels in infants with PVL group were significantly higher than those of control group at 1st,3rd,7th and 14th d after birth ( P ＜ 0.05 ).(2) The serum S100B levels increased on day 1,day 3 and day 7 [ (3.82 ±0.68),(4.41 ±0.91,),(5.78 ± 1.54) μg/L],peaked on day 7,and then decreased.The S100B levels of infants in PVL group were significantly higher than those of control group at 1st,3rd and 7th d after birth (P ＜0.05) ;and decreased on day 14 (P＞0.05).(3) Infants whose MBP and S100B levels increased at 7th day after birth had significantly decreased DQ than those of normal infants ( P ＜0.05 ).Conclusion The serum MBP and S100B levels in infants with PVL are correlated with the severity of central nervous system injury.If the serum S100B and MBP levels of PVL infants continues to rise more than 7 d,the DQ are lower,and the outcomes are poor.