新生儿高胆红素血症血清神经元特异性烯醇化酶测定的临床价值

目的 研究新生儿特异性烯醇化酶（NSE）与新生儿高胆红素血症之间的关系，以探讨高胆红素血症新生儿脑损害早期诊断的客观依据。方法 利用放免法对124例高胆红素血症足月新生儿及40例正常足月新生儿进行血清NSE测定，对81例NSE升高的新生儿进行脑干听觉诱发电位（BAEP）测试，并于生后12～18个月进行智能测定。结果 NSE水平在胆红素重度升高、中度升高、轻度升高组均增高，与对照组之间差异有显著性，P〈0．01。BAEP异常率、智能发育指数（PDI）及运动发育指数（MDI）下降在轻度升高组与对照组、重度升高组与中度升高组之间差异有显著性，但在轻度升高组与中度升高组之间差异无显著性。结论 NSE水平的测定较以BAEP及智能测定来判断新生儿高胆红素脑损害更早、更敏感，NSE可作为判断高胆红素血症新生儿发生脑损害早期预后指标之一。

The clinical value of sermn neuron-specific enolase in neomatal hyperbilirubinemia

Objective To explore the relationship between neuron - specific enolase (NSE) and neonatal hyperbilirubinemia. Methods Serum NSE level of 124 full term newborn infants with hyperbilirubinemia and 40 cases of healthy full term infants were measured by radioimmunoassay. Eighty - one bobies with high - NSE - level were evaluated by Brainsterm Auditry Evoked Potential (BAEP), and were followed - up at age of 12 - 18 months. Results There was significant difference in NSE level between severe hyperbilirubinemia group and moderate one. So was between moderate and mild, mild and control groups (P < 0.01) . BAEP became abnormal in babies with jaundice. MDI and PDI decreased in those babies. There was significant difference between severe and moderate hyperbilirubinemia groups, mild and control groups. But serum NSE level was not different between mederate and mild groups. Conclusions Serum NSE level is earlier and more sensitive than BAEP and cognitive estimation to ascertain neonatal cerehral damage with jaundice. NSE can be a new criterion to estimate late prognosis in infants' cerebral injury with gyperbilirubinemia.