血清S100B蛋白和神经元特异性烯醇化酶在缺氧缺血性脑病诊断与预后判断中的价值

目的探讨血清S100B蛋白和神经元特异性烯醇化酶(neuron-specific enolase,NSE)在新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)诊断与预后判断中的价值。方法 65例HIE患儿根据病情严重程度分为轻度HIE组(n=22),中度HIE组(n=24),重度HIE组(n=19),同期选择27例正常足月新生儿作为对照组。采用电化学发光免疫法、ELISA法动态检测各组血清NSE、S100B蛋白表达水平,同时比较各组NBNA评分和分析三者之间的相关性。结果 HIE患儿各组血清S100B蛋白、NSE水平均显著高于对照组(P0.05),而NBNA评分显著低于对照组(P0.05),且随病情程度加重而明显增加或降低(P0.05);HIE患儿血清S100B蛋白、NSE水平与NBNA评分呈负相关(P0.05),而血清S100B蛋白与NSE水平呈正相关(P0.05);随病情程度加重,HIE患儿血清S100B蛋白、NSE水平明显升高(P0.05),随时间延长,血清S100B蛋白、NSE水平则明显降低(P0.05)。结论动态监测血清S100B蛋白、NSE水平对新生儿HIE早期诊断、病情程度判断和治疗效果评价具有重要的临床价值。

Diagnosis and prognosis value of serum S100B protein and neuron-specific enolase in hypoxic-ischemic encephalopathy

Objective To investigate the diagnosis and prognosis value of serum S100B protein and neuron-specific enolase (NSE) of hypoxic-ischemic encephalopathy (HIE). Methods A total of 65 cases of HIE children were divided into three groups according to the severity of the patient's condition:mild HIE group (n=22),moderate HIE group (n=24),severe HIE group (n=19);Correspondingly,27 cases of normal full-term newborns at the same period were selected as control group.Electrochemiluminescence immunoassay,ELISA method were applied to dynamically detect the serum NSE,S100B protein levels of the four groups while the NBNA score between each groups was compared,and the correlations among the serum NSE,S100B protein levels and NBNA score were studied as well. Results The serum S100B protein,NSE levels of each HIE group were significantly higher than those of control group (P<0.05),while the NBNA scores were significantly lower than those of control group (P<0.05),and they significantly increased or decreased according to the degree of illness aggravating (P<0.05);The serum S100B protein and NSE levels of HIE children were negatively correlated with the NBNA score (P<0.05),whereas the serum S100B protein and NSE levels were positively correlated (P<0.05);Along with the illness degree aggravating,serum S100B protein,NSE levels of HIE children significantly increased (P<0.05),besides,with extension of the time,the serum S100B protein and NSE levels reduced significantly (P<0.05). Conclusion Dynamic monitoring of serum S100B protein and NSE level has important clinical evaluation value for early diagnosis,judgment of illness degree and treatment effectiveness of neonatal HIE.