MRI联合血清脑源性神经营养因子及神经元特异性烯醇化酶对高胆红素血症患儿诊断及转归的临床价值

目的探索MRI联合血清脑源性神经营养因子（BDNF）、神经元特异性烯醇化酶（NSE）对高胆红素血症患儿诊断及转归的临床意义。方法选取2017年3月~2019年8月在本院住院患有高胆红素血症的新生儿60例作为研究对象，其中男34例，女26例，胎龄38.4±1.6周；同期选取在本院住院的新生儿40例作为对照组，男19例，女21例，胎龄37.8±1.5周，比较两组新生儿血清BDNF、NSE水平及转归情况；根据MRI影像学表现，将高胆红素血症患儿分为MRI异常组和MRI正常组，比较血清BDNF、NSE水平；考察MRI、BDNF、NSE作为诊断高胆红素血症的诊断价值。结果高胆红素血症组临床转归总有效率为50.00%，低于对照组的75.00%，两组转归有效率的差异具有统计学意义（P < 0.05）。高胆红素血症组中54例（90.00%）患儿见MRI信号异常；对照组中6例（15.00%）见头颅MRI异常，差异有统计学意义（P < 0.05）。高胆红素血症组患儿NSE、BDNF表达均高于对照组（P < 0.05）。MRI异常组患儿血清NSE和BDNF水平高于MRI正常组（P < 0.05）。MRI联合血清BDNF、NSE对高胆红素血症的诊断效果高于单因素诊断。结论MRI联合血清NSE、BDNF可为高胆红素血症患儿的早期诊断及转归提供观察依据。 

Clinical significance of MRI combined with serum BDNF and NSE in the diagnosis and outcome of newborns with hyperbilirubinemia

ObjectiveTo explore the clinical significance of MRI combined with serum brain-derived neurotrophic factor (BDNF) and neuron-specific enolase (NSE) in the diagnosis and outcome of newborns with hyperbilirubinemia.MethodsSixtycases of newborns with hyperbilirubinemia in our hospital from March 2017 to August 2019 were selected as the research group, including 34 males and 26 females, with the age of 38.4±1.6 weeks. In the same period, 40 newborns in our hospital were selected as the control group, including 19 males and 21 females, with the age of 37.8±1.5 weeks. The serum BDNF and NSE levels of two groups were compared. According to MRI imaging findings, patients in research group was divided into MRI abnormal group and MRI normal group. The serum BDNF and NSE levels of the subgroup were compared. Finally, the diagnostic value of MRI, BDNF and NSE as the diagnosis of hyperbilirubinemia were analyzed.ResultsThe total effective rate of clinical outcomes in the hyperbilirubinemia group was 50.00%, which was lower than that in the control group (75.00%). The difference of the effective rates between two groups was significant(P < 0.05). In the hyperbilirubinemia group, 54 children with abnormal MRI were accounting for 90.00%. Six patients in the control group with abnormal MRI were accounting for 15.00%, and the difference between two subgroups was significant (P < 0.05). The level of serum NSE and BDNF in the research group were significantly higher than those in the control group (P < 0.05). Serum NSE and BDNF levels in children with abnormal MRI were significantly higher than those in normal MRI (P < 0.05). The diagnostic effect of MRI combined with serum BDNF and NSE on hyperbilirubinemia was higher than single factor diagnosis.ConclusionMRI combined with serum NSE and BDNF can provide observational basis for the early diagnosis and outcome of children with hyperbilirubinemia.