S100B蛋白及其脑损伤相关指标与新生儿缺氧缺血性脑病的关系

Relations of S100B protein and brain injure-related indicators in neonates with hypoxic ischemic encephalopathy

目的探讨新生儿血浆S100B蛋白及脑损伤相关指标肾上腺髓质素（ADM）、神经元特异性烯醇化酶（NSE）、脑型肌酸激酶同功酶（CK—BB）与缺氧缺血性脑病（HIE）的关系及意义。方法选择54例临床诊断为HIE的新生儿，在出生12h时抽血检测血浆SIOOB、ADM、NSE和CK—BB水平，与47例非HIE窒息新生儿和22名健康新生儿的血浆上述指标水平进行方差分析，两两比较采用成组设计资料t检验，采用Spearman线性相关分析法分析HIE新生儿血浆S100B蛋白与其他各指标间的关系。结果出生12h时HIE患儿血浆S100B为（0．93±0．43）HgZL，ADM为（144．12±18．55）ng／L，NSE为（32．76±18．92）μg／L，CK—BB为（52．89±21．49）U／L，高于窒息组的（0．34±0．16）μg/L，（106．48±20．62）ng／L，（11．22±3．31）μg／L和（20．87±11．55）U／L，也高于对照组的（0．27±0．10）μg/L，（96．51±20．86）ng／L，（9．96±2．41）μg／L和（20．93±11．24）U／L（F〉44．740，P均〈0．01）；相关性分析显示HIE患儿血浆S100B水平与ADM、NSE、CK—BB呈正相关（r=0．429，0．694和0．503，P均〈0．01）。结论HIE患儿出生12h时血浆S100B、ADM、NSE和CK—BB水平能预示HIE患儿的脑部是否有缺血性损伤，且该4项指标关联度高，有助于HIE的早期诊断和预后判断．

Objective Hypoxic ischemic encephalopathy （HIE） is the frequent disease in neonates, and there is important significance of early diagnosis about serological analysis. This article was aimed to discuss the relations of S100B, adrenomedullin（ADM） , neuron specific enolase（NSE） , and creatine kinaes BB isozyme（CK-BB） in neonates with HIE. Methods Blood tests of S100B, ADM, NSE and CK-BB in 54 neonates with clinical diagnosis of HIE were performed at the point of 12 h after birth. The results were compared with 47 asphyxial neonates without HIE and 22 healthy neonates. The statistical analysis was done with one-way ANOVA and independent samples t-test. The correlations between S100B protein and other brain injury-related indicators were finished with Spearman bivariate correlations. Results The concentration of SIOOB （0.93 ±0. 43） μg/L, ADM （144.12 ±18.55 ） ng/L, NSE （32.76 ±18.92） μg/L and CK-BB （52.89±21.49） U/L in neonates with HIE was obviously higher than that in asphyxial group （ （0.34 ±0.16 ） μg/L, （ 106.48 ±20.62 ） ng/L, （ 1 1. 22 ±3.31 ） μg/L, （20. 87 ±11.55） U/L） and control group （（0.27±0.10） μg/L, （96.51 ±20.86）ng/L, （9.96±2.41） μg/L, （20.93±11.24） U/L; F〉 44. 740, P 〈 0.01 ） ; the correlation analysis indicated that there was a positive correlation between the concentration of S100B in neonate with HIE and ADM, NSE or CK-BB （r = 0. 429, 0. 694, 0. 503, all P 〈 0. 01）. Conclusion Factors of S100B, ADM, NSE and CK-BB would be of value in early diagnosis and early prediction the outcomes of neonates with HIE.