血清NSE、S100B和IL-6在早产儿脑损伤的临床应用

目的探讨早产儿脑白质损伤（WMD）发病率及临床表现；研究早产儿WMD早期神经元特异性烯醇化酶（NSE）、S100B蛋白（S100B）及白细胞介素-6（IL-6）值的关系。方法选取早产儿60例，据颅脑超声和头颅MRI检查分为WMD组（18例）及无WMD作为对照组（42例），分别于出生后24 h内、7 d后采2组静脉血，应用化学发光法检测S100B、NSE和IL-6。结果早产儿中WMD发生率为29.03%。WMD组惊厥、呼吸暂停、反应差所占比例均高于无对照组（P < 0.05）。WMD组早产儿出生后24 h内、7 d后NSE、S100B、IL-6水平均高于对照组（P < 0.05~P < 0.01）；组内比较，2组早产儿出生后7 d NSE、S100B、IL-6水平均下降，低于出生24 h内（P < 0.05~P < 0.01）。结论血清NSE、S100B和IL-6水平与WMD严重程度存在相关性，WMD早产儿S100B、NSE及IL-6在生后24 h内值均显著升高，S100B与IL-6升高持续时间长，则病情越严重，则死亡风险也就越高，对WMD的早期诊断有重要指导意义。

Clinical application value of the serum levels of NSE,S100B and IL-6 in premature infants with brain injury

ObjectiveTo investigate the incidence rate and clinical manifestations of premature infants with white matter damage(WMD), and explore its correlation with the serum levels of neuron-specific enolase(NSE), S100B and interleukin 6(IL-6).MethodsSixty preterm infants were divided into the WMD group(18 cases) and control group(42 cases, non-WMD) according to the results of cranial ultrasound and head MRI examination.The serum levels of S100B, NSE and IL-6 were detected using chemiluminescence after 24 h and 7 d of birth.ResultsThe incidence rate of WMD in preterm infants was 29.03%.The proportion of convulsion, apnea and poor response in WMD group were higher than those in control group(P < 0.05).The levels of S100B, NSE and IL-6 in WMD group were higher than those in control group after 24 h and 7 d of birth(P < 0.05 to P < 0.01).The levels of S100B, NSE and IL-6 in two groups after 7 d of birth decreased, which was lower than those after 24 h of birth(P < 0.05 to P < 0.01).ConclusionsThe serum levels of NSE, S100B and IL-6 are related to the severity of WMD.The levels of S100B, NSE and IL-6 in preterm infants with WMD significantly increase after 24 h of birth.The longer the levels of S100B and IL-6 elevating duration is, the more serious the disease is, and the higher the risk of death is, which has important guiding significance in the early diagnosis of WMD in preterm infants.