目的:系统评价人S100B蛋白与新生儿脑损伤的关系。方法:以"S100B、新生儿、脑损伤"为检索词,联合检索中国知网期刊全文数据库和万方数据库,以"S100B、neonate、brain injury"为检索词,联合检索Cochrane图书馆、PubMed、EMBASE、Web of Science,时间跨度均从建库至2016-03,获得新生儿脑损伤对生物体液中S100B蛋白水平影响相关的文献,并对纳入文献进行资料摄取和质量评价。采用Cochrane图书馆Rev Man 5.2软件对文献进行Meta分析。结果:共检索196篇文献,最后纳入19篇,其中有14篇与新生儿缺氧缺血性脑病(HIE)有关,2篇与围产期其它危险因素(宫内发育迟缓、脐动脉异常)所致的新生儿脑损伤有关,3篇与足月儿高胆红素血症所致脑损伤有关。高质量文献(NOS≥7分)17篇,余2篇NOS为5分。Meta分析HIE致脑损伤新生儿血液和尿液S100B蛋白水平较对照组升高,均数差(MD)分别为0.71和0.73(95%CI:0.52-0.90、0.07-1.39);围产期其它危险因素所致脑损伤新生儿脐带血S100B蛋白水平较对照组升高,MD=2.15(95%CI:1.72-2.59);足月儿高胆红素血症致脑损伤新生儿S100B蛋白水平亦较对照组升高,MD=1.42(95%CI:1.03-1.81)。11篇HIE致脑损伤研究存在文献发表偏倚。结论:新生儿几种生物体液中S100B蛋白水平升高对其脑损伤可能有早期提示作用。
Objective:To systematic evaluate the relationship of S100 Bprotein and neonatal brain injury.Method:Obtained the documents about the effect of neonatal brain injury on S100 Bprotein level in biological fluids by searching the Cochrane library,PubMed,EMBASE,Web of Science,CNKI and WanFang Database(from building a datebase to March 2016)with the index words of S100 B,neonate and brain injury.Evaluated the quality of the included studies and absorb the information one by one.Then the meta-analysis was performed by review manager version 5.2.Results:A total of 196 documents retrieved for the evaluation,19 of the literatures could be included into the Meta-analysis including 14 articles related to hypoxic-ischemic encephalopathy(HIE),2articles related to perinatal risk factors(intrauterine growth retardation,abnormal umbilical artery),3articles related to bilirubin-induced neurotoxicity in term neonates.There were 17high-quality literature(NOS≥7points).The remainig 2documents NOS score is 5points.There was a significant difference of S100 Bprotein level in blood of neonates with brain injury caused by HIE,S100 Bprotein combined MD=0.71(95% CI:0.52-0.90).There was a significant difference of S100 Bprotein level in urine of neonates with brain injury caused by HIE,S100 Bprotein combined MD=0.73(95%CI:0.07-1.39).There was a significant difference of S100 Bprotein level in the brain injury caused by perinatal risk factors(intrauterine growth retardation,abnormal umbilical artery),S100 Bprotein combined MD=2.15(95%CI:1.72-2.59).There was a significant difference of S100 Bprotein level in term neonates with brain injury caused by hyperbilirubinemia,S100 Bprotein combined MD=1.42(95% CI:1.03-1.81).There exist publication bias in the 11 literature about brain damage caused by HIE.Conclusion:Neonatal brain injury caused by HIE,perinatal risk factors(intrauterine growth retardation,abnormal umbilical artery)and hyperbilirubinemia will increase S100 Bprotein levels in blo