血清烯醇化酶和肌钙蛋白Ⅰ及β_2-微球蛋白水平变化在新生儿窒息中的临床意义

Clinical significance of serum NSE, cTnI and β_2-MG in neonates with asphyxia

目的:探讨血清烯醇化酶和肌钙蛋白Ⅰ及β2-微球蛋白在新生儿窒息中的变化及其意义。方法:选择24例窒息新生儿(轻度窒息14例,重度窒息10例)和26例同期正常足月新生儿为研究对象。在出生后24h内和治疗后第7d分别抽血,采用ELISA法及乳腺增强免疫比浊法检测各组血清烯醇化酶、肌钙蛋白Ⅰ及β2-微球蛋白含量。结果:(1)窒息新生儿出生第1d血清烯醇化酶、肌钙蛋白Ⅰ及β2-微球蛋白含量均显著高于对照组(P均<0.01),且重度窒息组较轻度窒息组差异有统计学意义(P<0.01);(2)窒息患儿经7d治疗,重度窒息组较对照组(P<0.01)和轻度窒息组(P<0.05)差异有统计学意义,轻度窒息组较对照组差异无统计学意义(P>0.05);轻、重度窒息组较出生时各参数含量显著下降(P<0.01)。结论:(1)血清烯醇化酶、肌钙蛋白Ⅰ及β2-微球蛋白水平变化与窒息程度密切相关;(2)新生儿窒息时伴有脑、心、肾等多脏器的损伤,轻度窒息儿经治疗在短期内即可恢复,重度窒息儿不能快速恢复,对预后判断具有重要临床价值。

Objective To investigate the variation and clinical significance of serum NSE, cTnI and β2-MG in apnoea neonatorum. Methods Twenty-four neonates suffered from suffocation （14 were light degree apnoea neonatorum and 10 were heavy degree apnoea neonatorum） and 26 synchronized normal full-term neonates were selected as the controls. The contents of serum serum NSE, cTnI and β2-MG were determined with ELISA method and enzymic method in 24 hours after birth and on the 7th day after treatment respectively. Results （1） The contents of serum NSE, cTnI and β2-MG in the suffocated neonates on the first day after birth were remarkably higher than control group （P〈0.01）, and the contents in the heavy degree apnoea neonatorum were raised compared with light degree apnoea neonatorum （P〈0. 01）. （2） After 7-day treatment, there was a statistic difference in the contents of serum NSE, cTnI and β2-MG between the heavy degree group and control group （P〈 0. 01）, and between the heavy degree group and the light degree group （P（0. 05）. But there was no statistic difference in the contents between control group and the light degree group（P〉0.05）. The contents of serum NSE, cTnI and β2-MG were greatly decreased in both the heavy degree group and the light degree group after the 7-day treatment（P〈0. 01）. Conclusion （1） The levels of serum NSE, cTnI and β2-MG are closely related to the apnoeic degree. （2） Apnoea neonatorum is always accompanied by the damages of brain, heart, kidney and many other organs. The patients in the light degree group can recover from the damages in a short period, but those in the heavy degree group cannot recover soon, which has an important clinical value for the prognosis judgement in apnoea neonatorum.