新生儿缺氧缺血性脑病血清神经元特异性烯醇化酶与头颅CT的变化

目的：探讨血清神经元特异性烯醇化酶（NSE）和头颅CT在新生儿缺氧缺血性脑病（HIE）诊断中的作用。方法：选择足月HIE患儿50例为观察组（轻，中，重分别为15，23，12例），足月健康新生儿20例对照组，于出生后，3，7天分别取血清，用双抗体夹心酶联免疫法测定血清NSE，并于生后1周内行头颅CT检查。结果：HIE患儿生后3天NSE均升高，以中，重度增高明显，与临床分度一致，以后随病情好转而逐渐下降，重度HIE患儿头颅CT分度与临床分度一致，而轻，中度HIE患儿头颅CT与临床分度不完全一致。结论：血清NSE测定是早期诊断HIE及判断病情轻重，估计预后的有效指标，1周内头颅CT检查结合血清NSE测定能更好地帮助HIE的诊断。

Changes on Neuro-specific Enolase of Serum and Cranial Computed Tomography in Neonates With Neonatal Hypoxic Ischemic Encephalopathy

To study the role of neurospecific enolase(NSE) of serum and cranial computed tomography(CT) in diagnosis of neonatal hypoxic ischemic encephalopathy(HIE). Fifty neonates with HIE were divided into three groups by patient' condition:mild,moderate and severe group including 15,23 and 12 neonates respectively.Meanwhile,another 20 healthy neonates were taken as contrast.All samples of serum in neonates were obtained at postnatal day 3 and day 7.The levels of NSE in serum were estimated by enzyme linked immunoadsorbent assay.Neonates were checked by cranial CT in one week after being born. The levels of NSE in neonates with HIE especially those in the moderate and the severe group increased significantly in postnatal three days and then decreased gradually with improvement of patient' condition,which was consistent with clinical grade.The cranial CT of neonates in severe group was coincident with clinical grade but that in the mild and moderate group weren't completely consistent with it. Conclusion] The assay of NSE in serum is an operative index to diagnose HIE in earlier period,verdict patient' condition and estimate patient' prognosis.The combination of cranial CT in one week and assay of NSE in serum can offer a good help to diagnosis and therapy of HIE.