目的探讨脐血S-100B蛋白水平和神经行为评分(NBNA)对早产儿脑损伤早期诊断及预后评估的价值,并分析围产因素与早产儿脑损伤的关系。方法选取2012年1-12月该院收治的早产儿76例为研究对象,所有早产儿均行颅脑彩超及MRI检查,根据检查结果将脑损伤患儿纳入观察组、无脑损伤患儿纳入对照组。两组患儿均于出生后采集脐血,应用化学发光法检测S-100B蛋白含量;取其胎盘送检。对入选早产儿于出生后第3天、第14天、第28天(校正胎龄40周后算起)进行NBNA测定。结果观察组出生后脐血S-100B蛋白含量高于对照组,出生后第3天、第14天、第28天NBNA评分明显低于对照组,差异均有统计学意义(P均<0.05)。围产因素是早产儿脑损伤发生率增高的危险因素。结论脑损伤早产儿脐血S-100B蛋白水平的监测可作为一个敏感的标志物用于早期脑损伤的预测,NBNA评分有助于判断疾病严重程度及评估患儿预后,可为早期干预治疗提供客观依据。母亲合并妊娠期高血压疾病、胎盘绒毛膜炎、出生时胎龄是早产儿脑损伤发生率增高的危险因素。 Objective To investigate the value of umbilical cord blood S-100B protein level and neurobehavioral score (NBNA) in early diagnosis and prognosis of premature infants with brain injury and to analyze the relationship between perinatal factors and brain injury in premature infants. Methods Totally 76 preterm infants admitted to our hospital from January to December in 2012 were enrolled in this study. All preterm infants were examined by cranial ultrasound and MRI. According to the results, children with brain injury were included in the observation group and children without brain injury Control group. Cord blood was collected after birth in both groups, and the content of S-100B protein was detected by chemiluminescence assay. The placenta was taken for examination. The selected preterm infants were tested for NBNA on days 3, 14 and 28 after birth (corrected for gestational age after 40 weeks). Results The content of S-100B protein in cord blood after birth in observation group was higher than that in control group. The NBNA score on the 3rd, 14th and 28th day after birth was significantly lower than that of the control group (P <0.05) . The perinatal factor is a risk factor for the increased incidence of brain injury in preterm infants. Conclusion The monitoring of S-100B protein level in cord blood of premature infants with brain injury can be used as a sensitive marker for the prediction of early brain injury. The NBNA score can help determine the severity of the disease and evaluate the prognosis of children, and may provide early intervention treatment Objective basis. Mothers with gestational hypertension, placental chorioamisis and gestational age at birth are risk factors for the increased incidence of brain injury in preterm infants.