Relationship of plasma S100B and myelin basic protein level with brain damage in preterm infants / 中华实用儿科临床杂志

ABSTRACT

Objective To study the relationships of plasma myelin basic protein (MBP) and S100B level with periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH) and periventricular leucumalacia (PVL) in preterm infants.Methods There were 385 cases of preterm infants whose gestational age was less than 34 weeks and were admitted in NICUs of Guangzhou Women and Children's Medical Center of Guangzhou Medical University,Guangzhou Huadu District Maternal and Child Health Hospital and Dongguan Hospital Affiliated to Jinan University from Jan.2010 to Jun.2013,enrolled in the study.The plasma levels of S100B and MBP protein were detected within 24 hours and on the 3rd,7th,14th day after birth.Cranial ultrasound (US) was preformed 2-3 d,1 week,2 weeks,3 weeks and 4 weeks after birth.They also received Cranial MRI examination before discharge or when the correct gestational age reached 40 weeks.According to the exclusion standard 73 cases were excluded.The included 312 cases were divided into 3 groups (no brain damage group,PVH-IVH group and PVL group) according to the result of cranial US and MRI.The differences of the plasma levels of S100B and MBP protein among each groups were compared,and the relationship of the plasma levels of S100B and MBP protein in no brain damage group with gestational age were analyzed.Results The results of cranial ultrasound and/or MRI showed204 cases had no brain damage (put in no brain damage group),69 cases had PVH-IVH (put in PVH-IVH group),and 27 cases had PVL,12 cases had PVL and PVH-IVH (both put in PVL group).The plasma level of S100Bwithin 24h and 3 d after birth,the serum levels of S100B in PVH-IVH group were significantly higher than those in no brain damage group (P ＜ 0.05) ; and the plasma levels of S100B in PVL group were significantly higher than those in no brain damage group and PVH-IVH group (all P ＜ 0.05).On 7 d and 14 d after birth,there were no significant differences between PVH-IVH group and no brain damage group (P ＞ 0.05) ;and the plasma levels of S100B of PVL group were still significantly higher than those in no brain damage group and PVH-IVH group (all P ＜0.05).The plasma levels of MBPwithin 24 h,3 d,7 d and 14 d after birth,there were no significant differences between PVH-IVH group and no brain damage group (all P ＞ 0.05) ; and the plasma levels of MBP in PVL group were significantly higher than those in no brain damage group and PVH-IVH group (all P ＜ 0.05).Correlation analysis of gestational age and S100B and MBPthe plasma level of S100B in no brain damage group had negative correlation with gestational age (r =-0.483,P =0.006).The plasma level of MBP had no correlation with gestational age (r =-0.295,P =0.105).Conclusions The plasma levels of S100B and MBP increased significantly in preterm infants with brain damage within 24 h after birth,and the plasma levels of S100B and MBP of PVL infants were much higher than PVH-IVH infants.The increased plasma levels of S100B and MBP of PVL infants lasted longer than PVH-IVH infants.The increase of plasma levels of S100B and MBP in preterm infants would have certain clinical significance for judging whether early brain damage and PVL would happen.