关键词: 早产儿脑损伤, Tau蛋白, 近期预后, 白细胞介素-6, 振幅整合脑电图, 新生儿行为神经测定

Abstract: Objective To investigate the value of serum Tau protein in assessing brain injury in premature infants (BIPI) and the recent prognosis, so as to provide reference for the prevention and treatment of BIPI. Methods From January to December 2020, 92 premature infants hospitalized in the Neonatology Department of Tangshan Maternal and Child Health Care Hospital were consecutively included. According to the cranial B-ultrasound and MRI diagnosis results in corrected gestational age of 40 weeks, infants were divided into paraventricula-intraventricular hemorrhage(PIVH) group(n=24), periventricular leukomalacia(PVL) group(n=10) and non-brain injury group(n=58). Serum levels of Tau protein, interleukin-6(IL-6), amplitude electroencephalogram (aEEG) score and Neonatal Behavioral Neurological Assessment (NBNA) score were compared among the three groups. Results On the 1st, 3rd and 7th day after birth, serum levels of Tau protein and IL-6 were significantly different among PIVH group, PVL group and non-brain injury group (F=18.227, 20.273, 18.569, 16.375, 17.283, 18.144, P<0.01). Specifically, the levels of above indicators in PIVH group and PVL group were significantly higher than those in non-brain injury group (P<0.05), but the difference between PIVH group and PVL group was not significant (P>0.05). The aEEG scores within 1 week after birth, aEEG score and NBNA score at corrected gestational age of 40 weeks were significantly different among PIVH group, PVL group and non-brain injury group(F=15.352, 14.903, 16.284, P<0.05). In detail, the levels of above indicators in PIVH group and PVL group were significantly lower than those in non-brain injury group (P<0.05), but the difference between PIVH group and PVL group was not significant (P>0.05). Serum level of Tau protein was positively correlated with serum IL-6 level (r=0.822, P<0.05), and negatively correlated with aEEG score in the first week after birth, aEEG score and NBNA score at the corrected gestational age of 40 weeks (r=-0.695,-0.647,-0.682,P<0.05). The optimal threshold value of serum Tau protein in the assessment of BIPI was 183.39 pg/ml, and corresponding AUC, sensitivity and specificity was 0.820, 76.3% and 85.2%, respectively. There was no significant difference in the assessment value when predicting BIPI among serum Tau protein level, aEEG score in 1 week after birth, aEEG score and NBNA score at corrected gestational age of 40 weeks (P>0.05). Conclusions Serum level of Tau protein could reflect BIPI and the recent prognosis of infants. The occurrence of BIPI should be alerted when it exceeds 183.39 pg/ml.

Key words: brain injury in premature infants, Tau protein, short-term prognosis, interleukin-6, amplitude integrated electroencephalogram, neonatal behavioral neurological assessment