Application of serum Nesfatin-1 combined with amplitude-integrated EEG in the diagnosis of brain injury and short-term neurodevelopmental prediction in preterm infants
Objective To investigate the application value of serum Nesfatin-1 combined with amplitude-integrated electroencephalography(aEEG)in the diagnosis of brain injury and short-term neurodevelopmental prediction in preterm infants.Methods 89 preterm infants who were hospitalized in the neonatal intensive care unit of the Affiliated Hospital of Hebei University from February 2022 to March 2023 were selected as the research objects,divided into the combined brain injury group(n=50)and the uncomplicated brain injury group(n=39).The combined brain injury group was further divided into＜32 weeks group(n=24),32-33 weeks group(n=14)and 34-37 weeks group(n=12)according to gestational age.All enrolled preterm infants were tested for serum Nesfatin-1 levels within 24 hours after birth,aEEG within 72 hours,and cranial magnetic resonance imaging(MRI)during hospitalisation.Neonatal behavioral neurological assessment(NBNA)score was performed at corrected gestational age of 40 weeks,and the Gesell Developmental Scale was measured at corrected gestational age of 3 months.Correlation analyses were performed between serum Nesfatin-1,aEEG scores,NBNA scores and Gesell developmental quotient in each functional area.The application value of serum Nesfatin-1 combined with aEEG in the early diagnosis of brain injury in preterm infants was assessed by using receiver operating characteristic(ROC)curve.Results Serum Nesfatin-1 levels in the combined brain injury group were higher than those in the uncomplicated group,with lower aEEG scores and Gesell developmental quotients in each functional area,with statistically significant differences(Z=-8.039--3.030,P＜0.01).There was no statistically significant difference in serum Nesfatin-1 levels among pediatric patients of different gestational ages(P＞0.05).In the＜32 weeks gestational age group,aEEG continuity,waveband width and total score were lower compared to the 34-37 weeks gestational age group,and the 32-33 weeks gestational age group had lower aEEG continuity compared to the 34-37 weeks gestational age group,with statistically significant differences(H=10.766-24.600,P＜0.01).There was a significant negative correlation between serum Nesfatin-1 level and NBNA score and Gesell developmental quotient in each functional area(r=-0.582--0.438,P＜0.01).aEEG total score was significantly positively correlated with NBNA score and Gesell developmental quotient in each functional area(r=0.479-0.572,P＜0.01).The areas under the curve for serum Nesfatin-1 level,aEEG score and their combined in diagnosing brain injury in preterm infants were 0.868,0.834 and 0.903,respectively.Conclusion In preterm infants,serum levels of Nesfatin-1 from the combined brain injury group increase in the early postnatal period,while aEEG monitoring indices decrease,both of which are closely related to the neurodevelopment of preterm infants.
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