対象・方法：対象は1998年から2010年に当院NICUで脳低温療法を施行した72例中，修正1歳6ヵ月の新版K式発達検査を施行した36例と，そのうち修正3歳の新版K式発達検査まで施行した25例である。それぞれ各検討項目についてDQ75未満とDQ75以上の群について後方視的に比較検討した。
結果：修正1歳6ヵ月の新版K式のDQに影響を及ぼす因子として，出生場所・出生体重・Apgarscore5分値・出生時児血pH・出生時児血BaseExcess（BE）・髄液中NSE・血中CK-BBの最大値が挙げられた。一方，修正3歳の新版K式のDQに影響を及ぼす因子として，在胎期間・出生体重・髄液中NSEが挙げられた。また，修正1歳6ヵ月のDQに差を認める髄液中NSEのカットオフ値は34ng/mLであり，修正3歳のDQに差を認める髄液中NSE値は30ng/mLであった。
結論：修正1歳6ヵ月と修正3歳の新版K式のDQに共に影響を及ぼす因子として，出生体重・髄液中NSEが重要であると考えられた。また髄液中NSEが34ng/mL以上では修正1歳6ヵ月で，30ng/mL以上の症例では修正3歳で発達予後が不良である可能性が示唆された。
Subjects and methods：Subjects were 36 patients who completed the revised Kyoto scale of psychological developmental test（revised Kyoto scale）for 18-month-old infants and 25 patients who completed for 3-year-old infants from among the 72 patients who underwent brain hypothermia therapy at the NICU of our hospital between 1998 and 2010. Patients were classified by their development quotient（DQ）into the DQ＜75 and DQ≧75 groups and retrospectively compared with regard to each item.
Results：Factors associated with a significant difference in DQ at 18-month-old were places of birth（nosocomial or extramural），birth weight, Apgar score（5 minutes），pH at birth, Base Excess（BE）at birth, neuron-specific enolase（NSE） in cerebrospinal fluid（CSF），and the maximum creatine kinase-BB isoenzyme（CK-BB）during follow-up. On the other hand, factors associated with a significant difference in DQ at 3-year-old were gestational age, birth weight, NSE in CSF. In addition, the level of NSE in CSF at which a difference in DQ at 18-month-old was observed was 34ng/mL, and at 3-year-old was 30ng/mL.
Conclusion：These results suggest that birth weight, NSE in CSF are important factors affecting the DQ for 18-monthand 3-year-old infants, and that patients with an NSE in CSF of ≧34ng/mL have a poor prognosis for development at 18-month-old, and patients with an NSE in CSF of ≧30ng/mL at 3-year-old.
