早产儿血清NSE、IL-6水平测定对筛查脑性瘫痪高危儿意义的研究

The clinical study for screening the infants with the high risk factor for cerebral palsy by measuring the lever of interleukin-6 and neruon-specificenolase in premature serum

目的探讨早产儿脐血及静脉血IL-6和NSE的水平与脑损伤的关系以及用以辅助筛查出脑瘫高危儿人群的价值。方法选胎龄≤35w和/或出生体重<2000g的早产儿脐血32例,静脉血30例,足月儿脐血、静脉血对照各20例,检测血清IL-6、NSE水平。两组均随访至3岁(死亡及诊断为脑瘫者终止)。采用SAS6.12统计软件进行成组设计t检验或秩和检验。并以ROC曲线分析筛查值。结果1.早产儿脐血、静脉血组IL-6、NSE水平较各自对照组平均水平明显增高(P<0.05)。2.脑瘫组IL-6水平、脐血及静脉血NSE水平均显著高于非脑瘫组(P=0.0140、0.0255及0.0095)。结论IL-6、NSE水平与围产期脑损伤有关,以脐血IL-6≥305.03pg/ml,NSE≥8.1175μg/l作为筛查脑瘫高危儿标准时具有较好的灵敏度与特异度。

Abstract：Objective：The purpose of this clinical study was to explore the association of neonatal damage and interleukin - 6 （IL- 6）, neuron - specificenolase （NSE） concentration in umbilical cord plasma, serum in premature. To evaluate the value of these two biological mark- ers for screening the infant with the high risk factor for cerebral palsy （CP）. Methods ： Umbilical cord plasma was collected from 32 eases ≤ 35 weeks and/or birth weight 〈 2000g preterm births, vein serum was collected from 30 within 4 days of life preterm births, vein serum and umbilical cord plasma of term newborns were matched control for 20 examples respectively. IL - 6 and NSE was measured. And we followed these premature until 3 years old （or finishied being diagnosed cerebral palsy or death）. Statistical analysis was performed with t test or rank sum test and receiver operating characteristic curve was analysed by SPSSI0.0. Results： 1. There was higher expression of IL- 6 and NSE level in umbilical cord plasma and vein serum for their matched control group （P 〈 0.05） = .2.The children with cerebral palsy had significantly higher median concentrations of IL - 6 in serum and NSE in umbilical cord, in vein serum than those without cerebral palsy, the P value is respectively for 0.0140,0.0255 and 0.0095. Conclusion ： IL - 6 and NSE is associated with brain damage. IL - 6 lever ≥ 305.03 pgs/trd, NSE lever ≥8. 1175μg/l can be used as a monitoring criteria for screening the infant with the high risk factor for cerebral palsy（CP）.