儿童早期脑损伤血清神经元特异性烯醇化酶与发育行为异常的相关性研究

目的 探讨儿童早期脑损伤血清神经元特异性烯醇化酶(neuronspecific enolase,NSE)与后期发育行为异常的相关性.方法 选择我院出生的重度、中度、轻度HIE患儿各15例以及15例健康儿,采用酶联免疫吸附实验(enzyme linked immunosorbent assay,ELISA)测定血清中神经元特异性烯醇化酶的浓度,并进行新生儿行为神经测定(neonatal behavioral neurological assessment,NBNA)评分以及ASQ发育筛查系统(ASQ developmental screening system,简称ASQ-C评价).结果 两组儿童在性别、体重、分娩方式等指标上均不存在显著差异(P>0.05);重度、中度、以及轻度新生儿缺氧缺血脑病(hypoxic-ischemic encephalopathy,HIE)患儿之间血清NSE值存在显著差异(P<0.05),血清中NSE值随临床病征的加重而升高;实验组中重度、中度、以及轻度HIE患儿的血清NSE值均高于对照组,且差异存在统计学意义(P<0.05);重度、中度、以及轻度HIE患儿之间NBNA评分值存在显著差异(P<0.05),NBNA评分值随临床病征的加重而降低;实验组中重度、中度、以及轻度HIE患儿的NBNA评分值均低于对照组,且差异存在统计学意义(P<0.05);不同NBNA评分组之间血清NSE值存在显著差异(P<0.05),血清NSE值随着NBNA评分的增加而降低;实验组与对照组比较,重度、中度和轻度HIE组沟通区异常、大运动能区异常、精细动作能区异常较对照组皆存在显著差异(P<0.05);解决能力区异常、个人-社会能区异常上实验组与对照组不存在显著差异(P>0.05).结论 NSE以及NBNA评分与儿童早期脑损伤患儿的严重程度以及后期的发育行为异常相关.

Correlation between Neuron-Specific Enolase and the Late-Stage Behavioral Development of Early-Childhood Brain Damage

Objective To investigate the correlation between neuron-specific enolase (NSE) and the late-stage development of behavior after early-childhood brain damage.Methods 15 children with mild HIE,15 with moderate HIE,15 with severe HIE,15 healthy children born in our hospital,were studied.Enzyme linked immunosorbent assay was used to measure the concentration of neuron-specific enolase in serum.Moreover,neonatal behavioral neurological score and ASQ developmental screening system were used for the assessment of behavioral development.Results There was no significant difference between HIE children and their healthy counterparts in sex,body weight,delivery mode (P>0.05).Significant differences were found in serum NSE among children with severe,moderate and mild HIE (P<0.05 for all),with the clinical symptoms worsening as serum NSE increased.NSE value was significantly higher in HIE children than in the control group (P<0.05).There were significant differences in NBNA score among the three HIE groups (P<0.05),with the clinical symptoms deteriorating as NBNA score decreased.The NBNA scores were significantly lower in the HIE groups than in the control group (P<0.05).There existed significant differences in serum NSE values among groups among groups of different NBNA values (P<0.05).Serum NSE values decreased as NBNA score increased.There were significant differences between the HIE groups and control group in the abnormality in the domains of communication,gross motor and fine motor (P<0.05).There were no significant differences in the abnormality of solving and personal-social domains (P>0.05).Conclusion NSE and NBNA score are associated with the severity of brain damage and the late-stage behavioral development during early childhood.