缺血缺氧性脑病患儿肾上腺髓质素、神经元特异性烯醇化酶及脑型肌酸激酶同工酶的关系

目的探讨缺血缺氧性脑病（hypoxic ischemic encephalopathy，HIE）患儿血浆肾上腺髓质素（adrenomedullin，ADM）、神经元特异性烯醇化酶（neuron specific enolase，NSE）及脑型肌酸激酶同功酶（creatine kinaes BB isozyme，CK—BB）的关系及意义。方法选择57例临床诊断为HIE的新生儿在出生12h内抽血检测ADM、NSE和CK-BB，与62例非HIE的窒息新生儿和27例健康新生儿进行对照比较。结果HIE患儿血浆ADM、NSE和CK—BB水平显著高于窒息组和对照组（均P〈0．01），且HIE患儿ADM、NSE和CK—BB水平均随HIE的轻重程度增高而显著增高（均P〈0．01）；相关性分析显示HIE患儿血浆ADM水平与NSE、CK—BB呈正相关性（r=0．471，P〈0．01；r=0．619，P〈0．01）；NSE与CK-BB水平也呈正相关性（r=0．512，P〈0．01）。结论ADM、NSE和CK—BB均能较早的预示HIE患儿的脑部损伤，可能在HIE发病机制的代偿反应中表现关联一致，有助于HIE的早期诊断和排除诊断。

Relations of Adrenomedullin, Neuron Specific Enolase and Creatine Kinaes BB Isozyme in Neonates with Hypoxic Ischemic Encephalopathy

Objective To discuss the relations of adrenomedullin, neuron specific enolase and creafine kinaes BB isozyme in neonates with hypoxic ischemic encephalopathy. Methods ADM, NSE and CK-BB were tested on 57 neonates with clinical diagnosis of HIE in 12 hours after birth, then compared with 62 asphyxial neonates without HIE and 27 healthy neonates, Results The concentrations of ADM, NSE and CKBB in neonates with HIE are obviously higher than those in asphyxial group and control group（ average P 〈 0. 01）, and increased markedly with the severity of HIE（ average P 〈 0.01） ; the correlation analysis indicates that there is a positive correlation between the concentration of ADM in neonate with HIE and NSE or CK-BB（ r = 0.471, P 〈 0.01, r = 0.619, P 〈 0. 01 ） ; also between NSE and C K-BB （ r = 0.512, P 〈 0.01 ）. Conclusion ADM, NSE and CK-BB could predict the brain injury early in neonates with HIE, which probably represents consistent association in the compensatory reaction of HIE, it would be helpful for early diagnosis and ruling out diagnosis.