脑脊液神经元特异性烯醇化酶对高胆红素血症新生儿远期神经发育的预测价值

目的了解高胆红素血症足月新生儿远期神经发育状况，探讨脑脊液神经元特异性烯醇化酶（CSF-NSE）水平对远期神经发育的预测价值。方法采用首都儿科研究所与心理研究所制定的0～4岁婴幼儿精神发育量表对足月高胆红素血症及健康新生儿各39例进行3、24个月的智力发育随访；39例高胆红素血症足月新生儿在黄疸极期检测CSF—NSE水平。结果随访3、24个月均发现高胆红素血症足月新生儿总发育商（DQ）低于对照组，差异有统计学意义（P=0，0．047）；单项DQ比较显示精细动作和社交行为均明显低于对照组（Pa=0）；3、24个月DQ与CSF—NSE水平存在显著负相关（r=-0．46P=0．04；r=-0．32P=0．047），与TSB水平无明显关系（r=-0．21P=0．20；r=-0．30P=0．06）。结论高胆红素血症可能对远期智力发育有影响，CSF—NSE可作为判断高胆红素血症新生儿远期神经发育的预测因子之一。

Predictive Value of Cerebrospinal Fluid Neuron Specific Enolase on Long-Term Neurodevelopment Outcome in Neonates with Hyperbilirubinemia

Objective To study the long-term neurodevelopment in term neonates with hyperbilirubinemia and explore the predictive value of cerebrospinal fluid neuron specific enolase (CSF-NSE) on long-term neurodevelopment outcome.Methods A mental and psychomotor scale for 0-4 years old was performed to evaluate the intelligence development of 39 neonates with hyperbilirubinemia and 39 randomly selected healthy controls when they were at 3 to 24 months old. The former were tested for the level of CSF-NSE in jaundice climax.Results There was significant difference between 2 groups in total development quotient (DQ) tested at 3 month and 24 month old (P=0, 0.047). It was shown that the DQ scores for fine activity and social behavior were significantly lower in the study group than those in the control group (Pa=0). Furthermore, within the hyperbilirubinemia group, CSF-NSE was significantly associated with DQ of 3 month and 24 month old, while there was not association with TSB. The correlation coefficients were -0.46(P=0.04) and -0.32(P=0.047),respectively.Conclusions Hyperbilirubinemia may influence long-term neurodevelopment of term infants and CSF-NSE can predict this outcome.