Abstract:
Objective To explore the value of cerebral hemodynamics parameters combined with serum levels of High-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in the early diagnosis of brain injury in premature infants (BIPI).
Methods From January 2021 to January 2024, 94 premature infants with gestational age≤32 weeks and birth weight<1500 g were admitted to the Neonatal Intensive Care Unit of Huanggang Central Hospital. Cranial magnetic resonance imaging (MRI) was performed before discharge or at a corrected gestational age of 36 weeks. The diagnosis of BIPI was based on Expert Consensus on Diagnosis and Prevention of Brain Injury in Premature Infants. Infants were assigned to the BIPI group (n=36) and non-BIPI group (n=58). The cerebral hemodynamic parameters of middle cerebral artery (MCA) including peak systolic velocity (Vs) and resistance index (RI) and serum levels of hs-CRP and IL-6 were analyzed and compared between the two groups on the third postnatal day. Binary Logistic regression analysis was used to identify risk factors for BIPI. The diagnostic value of serum hs-CRP and IL-6 levels, hemodynamic parameters of MCA (Vs, RI), and their combination for early BIPI were evaluated using receiver operating characteristic (ROC) curve analysis.
Results Univariate Analysis showed that the incidence of volume expansion and hyperglycemia within 3 d, Vs, RI, hs-CRP and IL-6 levels in BIPI group were higher than those in non-BIPI group (P<0.05). Logistics regression analysis showed that volume expansion and hyperglycemia within 3 d, Vs, RI, hs-CRP, IL-6 were independent risk factors of BIPI on the third postnatal day. ROC curve analysis shows that the areas under the curve (AUC) (95%CI) of serum hs-CRP, IL-6 level, Vs, RI alone and the combined prediction of BIPI were 0.762 (0.659-0.864), 0.780 (0.674-0.885), 0.785 (0.675-0.896), 0.696 (0.572-0.821), and 0.940 (0.894-0.985), respectively, compared with hs-CRP, IL-6, Vs and RI, the AUC of the combined prediction was higher (P<0.05).
Conclusions The combination of serum hs-CRP, IL-6, Vs and RI has good predictive efficacy for early diagnosis of BIPI.
Key words:
Brain injury,
Premature infant,
Cerebral hemodynamic parameters,
High-sensitivity C-reactive protein,
Interleukin-6,
Early diagnosis
Dandan Peng, Min Wang, Jun Li, Chong Zeng, Ling Zeng, Yulian Hu. Value of cerebral hemodynamic parameters combined with hs-CRP and IL-6 in the early diagnosis of brain injury in premature infants[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2025, 15(06): 352-357.