关键词: 低血糖, 神经元特异性烯醇化酶, 振幅整合脑电图, 视频脑电图, 足月儿

Abstract: Objective To analyze the change trend and characteristics of neuron specific enolase (NSE), amplitude integrated electroencephalograghy (aEEG) and video electroencephalogram (VEEG) in term infants, in order to provide clinical reference for assessing brain injury and brain function changes in term infants with different blood glucose levels. Methods A total of 83 full-term neonates diagnosed with neonatal hypoglycemia were selected from the Affiliated Hospital of Weifang Medical College from January to August 2019.According to the minimum blood glucose level, the objects were divided into mild hypoglycemia group (39 cases)(2.2 mmol/L≤blood glucose＜2.8 mmol/L), moderate hypoglycemia group(31 cases) (1.1 mmol/L≤blood glucose＜2.2 mmol/L) and severe hypoglycemia group(13 cases) (blood glucose＜1.1 mmol/L).Meanwhile, 40 neonates with normal blood glucose with high risk factors were selected as control group.Children with hypoglycemia were tested every 3 hour.aEEG was performed 6 hours after that two consecutive blood glucose tests were in normal range.Newborns in control group were given 6 hours of aEEG in 72 hours.VEEG was detected in both groups within 12 hours after aEEG.Serum NSE levels were measured on the 1st, 3rd and 5th day.Rank sum test was used for aEEG and VEEG, t test was used for the change of NSE, and F test was used for intergroup comparisons. Results 1) The incidence of pregnancy-induced maternal blood glucose elevation was statistically significant among each group (P=0.03).2) The level of NSE in neonates with hypoglycemia was higher.There were significant differences on NSE level among children with different blood glucose levels (F=965.759, P<0.001), and there was an interaction effect on NSE level between time and blood glucose values (F=31.14,P＜0.001).3)There were significant differences on sleep-wake cycle(SWC) and total score of aEEG among mild, moderate and severe hypoglycemia groups (H=25.192,17.824, P＜0.01).The total score, SWC and bandwidth in severe hypoglycemia group were significantly lower than those of control group(U=113.0, 111.5, 188.0), and the total score and SWC were lower than those in mild hypoglycemia group (U=132.5, 110.5,P＜0.05).The total score and presence of cyclic changes in electrical activity of moderate hypoglycemia group were significantly lower than those of control group (U=366.0, 348.5)and mild hypoglycemia group (U =420.5, 344.5, P＜0.05).4) VEEG result was normal in all groups. Conclusions NSE level is different in children with different blood glucose levels, which can be used as an index to evaluate the possibility and degree of brain injury in children with simple hypoglycemia.Moderate and severe hypoglycemia can lead to changes in neonatal aEEG, mainly in SWC changes.However, VEEG can not be a sensitive index for hypoglycemia.

Key words: hypoglycemia, neuron specific enolase, amplitude integrated electroencephalograghy, video electroencephalogram, term infant