血浆S100B蛋白在缺氧缺血性脑病新生儿的诊断评估

Diagnostic value of plasma S100B protein in neonates with hypoxic ischemic encephalopathy

目的探讨血浆S100B蛋白对缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)新生儿脑损伤的临床意义。方法选择54例临床诊断为HIE的新生儿在出生12 h时抽血检测S100B、神经元特异性烯醇化酶(neuron specificenolase,NSE)及脑型肌酸激酶同功酶(creatine kinaes BBisozyme,CK-BB),与47例非HIE的窒息新生儿和22例健康新生儿进行对照比较。评价敏感性和特异性,绘制ROC曲线,计算ROC曲线下面积。结果出生12 h时HIE患儿血浆S100B、NSE和CK-BB阳性率显著高于窒息组和对照组(均P<0.01),S100B对HIE的敏感性为88.89%,特异性为82.61%,之和高于NSE及CK-BB。S100B的ROC曲线下面积最大(面积:0.950;95%可信区间0.918-0.983),临床诊断效能高于NSE及CK-BB。结论HIE患儿出生12 h时血浆S100B、NSE和CK-BB均能预示HIE患儿的脑部损伤,S100B阳性率最高,三指标联合检测,有助于HIE的早期诊断和病情判断。

Objective To discuss the Diagnostic value of plasma S100B protein in neonates with hypoxic ischemic encephalopathy （HIE） .Methods Blood testing S100B,NSE and CK-BB on 54 neonates with clinical diagnosis of HIE at the point of 12 hours after birth, then comparing with 47 asphyxial neonates without HIE and 22 healthy neonates, calculating the sensitivity and specificity of detection, protracting ROC curve and calculating the area below the ROC curve. Results The positive rates of S100B, NSE and CK-BB in neonates with HIE is obviously higher titan that in asphyxial group and control group （average P 〈 0.01 ）. The sensitivity and specificity of S100B to HIE is 88.89% and 82.61%, and the sum of sensitivity and specificity could be the most. With the largest area below ROC curve （area：0.950;95% credible interval 0. 918 - 0. 983）, S100B has the better efficiency than NSE and CK-BB in clinical diagnosis. Conclusion S100B, NSE and CK-BB could predict the brain injure early in neonates with HIE at the point of 12 hours after birth, The positive rate of S100B was the highest. Which has an important meaning in adjuvant diagnosing and ntling out diagnosis early HIE in the detection united with NSE and CK-BB.