血清酸性钙结合蛋白S-100对胆红素脑病早期诊断的意义

目的通过检测新生儿高胆红素血症患儿血清酸性钙结合蛋白S-100的变化,探讨其在该病诊断和预后判断中的作用。方法选择于2009年1月-2011年2月在我科住院的足月新生儿黄疸患者46例为观察对象,其中26例诊断为生理性黄疸（胆红素〈256μmol/L,根据实用新生儿学诊断标准）为B组,20例重度高胆红素血症（胆红素≥342μmol/L）为C组。临床诊断为胆红素脑病患儿11例为D组;同期正常无黄疸足月新生儿20例为对照组A组.各组病例均除外新生儿缺氧缺血性脑病,颅内出血等疾病。清晨留取静脉血4 ml,取血清标本,测血清总胆红素和-间接胆红素值,并采用双抗体夹心ELISA方法检测S-100蛋白浓度。结果对照组（A组）与生理性黄疸组（B组）血清S-100蛋白浓度分别为0.285±0.116和0.315±0.121μg/L,两组间比较P〉0.05,无明显差异;重度高胆红素血症组（C组）血清S-100蛋白浓度为0.493±0.212μg/L,胆红素脑病组（D组）为0.865±0.392μg/L,两组之间比较结果具有显著差异,P〈0.05。而B组和C组比较血清S-100浓度也有显著差异,P〈0.05。结论血清S-100蛋白浓度作为神经系统损伤的特异生化指标,可提示新生儿胆红素脑病的发生,并能反映其严重程度,提示预后判断。

The early diagnosis value of serum acidic calcium combined with protein s-100 on neonatal hyperbilirubinemia

Objective To discuss the effect on diagnosis and prognostic judgement through detecting patients having neonatal hyperbilirubinemia the transformation of Serum acidic calcium combined with protein s-100;Methods 46 patients having neonatal hyperbilirubinemia were selected,they were treated in hospital during 2009.1-2011.2.26 patients who have been diagnosed physiologic jaundice（bilirubin levels is lower than 256 μmol/L,on the basis of Newborn babies learn practical diagnostic criteria）were divided into B group,20 patients having Severe hyperbilirubinemia（bilirubin levels is equal or greater than 342 μmol/L） were divided into C group.11 patiens have been diagnosed bilirubin encephalopathy were divided into D group.In the same term,20 Without icteric term newborns are Control Group called A.No one has neonatal hypoxic ischemic encephalopathy or intracranial hemorrhage.On the morning taking 4ml venous blood,then,taking serum samples,detecting Serum total bilirubin and indirect bilirubin level,then adopting double antibody sandwich ELISA method detection S-100 protein concentration.Results compare A with B,serum S-100 protein concentration is separately 0.285±0.116 and 0.315±0.121 μg/L,there is no difference between the two groups（P〉0.05）;serum S-100 protein concentration is 0.493±0.212 μg/L in C,serum S-100 protein concentration is 0.865±0.392 μg/L in D,comparison between the two groups have significant differences（P〈0.05）.Comparing between B and C,serum S-100 protein concentration has significant differences（P〈0.05）.Conclusion serum S-100 protein concentrations as a neurological damage and specific biochemical index may indicate the occurrence of neonatal bilirubin encephalopathy,and can reflect their extent,tip prognosis