新生儿缺氧缺血性脑病颅脑MRI与Apgar评分、血清NSE相关性研究

目的探讨新生儿缺氧缺血性脑病（HIE）颅脑磁共振成像（MRI）改变与血清神经元特异性烯醇化酶（NSE）及新生儿评分（Apgar评分）之间的关系。方法选取HIE患儿100例（早产儿50例,足月儿50例）为实验组,依据颅脑MRI表现程度分为轻度HIE和中重度HIE组;另选同期非HIE新生儿40例为对照组,均在其生后行Apgar评分、检测血清NSE浓度,并于生后3~7 d行颅脑MRI检查。结果 HIE足月儿和早产儿随着MRI表现程度加重,血清NSE值逐渐增高,Apgar评分逐渐降低。中重度组与轻度组、对照组相比NSE水平差异显著,但轻度组与对照组差异不明显。5 min Apgar评分两两比较差异明显。结论外周血清NSE值与Apgar评分可作为临床早期评价HIE新生儿脑损伤严重程度的客观指标,且与头颅MRI分度基本一致。临床上可通过2指标的评定对HIE患儿进行早期诊断与干预。

Study on brain MRI and its relations to Apgar scores,serum level of NSE in patients with neonatal hypoxic ischemic encephalopathy

Objective To investigate the change of cerebral MRI of neonatal Hypoxic Ischemic Encephalopathy（HIE）,and the relation between the serum neuron-specific enolase（NSE） and Apgar scores.Methods One hundred HIE cases were chosen as experimental group,including 50 preterm cases and 50 term neonates.Based the degree of MRI,the subjects in the experimental group were classified into HIE mild and HIE moderate and severe.Another forty normal ones were chosen as control group.Blood samples were collected in all the research objects for NSE detecting.MRI was performed 3~7 days after birth in the experimental group.Results In full term neonates and preterm neonates,as the aggravation of the degrees of MRI,the serum NSE levels got increased and Apgar scores got decreased.Compared with the control group and the HIE mild group,the NSE levels in the HIE moderate and severe group had significant differences.However,the differences between the mild HIE group and the control group was insignificant.Differences of 5 min Apgar score between any two groups were significant.Conclusion Serum NSE level and Apgar score can be used as the early objective markers for evaluating the prognosis of brain damage in hypoxic ischemic encephalopathy,and they are concordance with the cerebral MRI degrees.We can perform early diagnosis and evaluation of HIE by utilizing the two indexes.