GPBB、CTnI、NSE在新生儿缺氧缺血性脑病中的临床意义

目的：探讨新生儿缺氧缺血性脑病（HIE）患儿血清糖原磷酸化同功酶BB（GPBB）、肌钙蛋白I（CTnI）、神经元特异性烯醇化酶（NSE）变化，为新生儿HIE的诊断、治疗及预后观察提供理论依据。方法：选择38例HIE患儿为对象（HIE组）根据病情分为轻度、中度、重度三组；同时选择32例同期出生的健康足月新生儿为正常对照组（对照组）。HIE组分别于急性期（入院后当天）及恢复期，对照组出生后（5～10）d采集静脉血检测血清GPBB、CTnI、NSE的浓度。结果：HIE组急性期血清GPBB、CTnI、NSE的浓度均高于对照组，差异具有显著性（P〈0．01）。轻度、中度、重度三组之间比较具有显著性差异（P〈0．01）。恢复期只有重度HIE患儿GPBB、CTnI、NSE的浓度仍高于对照组，差异具有显著性（P〈0．01）。而轻度、中度两组血清中GPBB、CTnI、NSE的浓度已恢复正常。结论：通过检测HIE患儿血清GPBB、CTnI、NSE的浓度有助于早期准确判断HIE患儿的心、脑损伤程度，预测HIE患儿的预后具有重要价值。

Clinical Significance of Determination of Serum Glycogen Phosphorylase BB(GPBB), CTnI and NSE Levels in Neonates with Hypoxicischemic Encephalopathy (HIE)

Objective To investigate the changes of serum glycogen phosphorylase BB(GPBB),cardiac troponin I(CTnI) and neuron specific enolase(NSE) levels in neonates with hypoxic-ischemic encephalopathy(HIE).Methods Serum GPBB,CTnI(with ELISA) and NSE(with RIA) levels were determined in 38 neonates with HIE(mild 18,moderate 12,severe 8) on the day of admission and during recovery as well as in 32 controls(5~10 days after birth).Results Serum GPBB,CTnI and NSE levels in all the neonates with HIE on the day of admission were significantly higher than those in the controls(P<0.01).Levels in the more advanced group of patients were also significantly higher than those in the less advanced ones(P<0.01).During convalescence,only the levels in the severe group(n=8) remained significantly higher than those in controls(P<0.01),while the levels in the mild and moderate groups were about the same as those in controls.Conclusion Serum levels of GPBB,CTnI and NSE levels in neonates with HIE were closely related to the severity of the disease and were of prognostic value.