S-100B蛋白在新生儿窒息缺氧缺血性脑病早期诊断中的价值

Predictive capacity of serum S-100B protein for hypoxic-ischemic encephalopathy after birth asphyxia

【目的】探讨血清S-100B蛋白浓度作为HIE早期诊断的价值。【方法】对52例新生儿分别采集脐血、生后12、24 h静脉血,采用ELISA法测定血清中S-100B蛋白的浓度水平。【结果】对照组与窒息组各时间段血清S-100B蛋白浓度差异均有显著性(P<0.01)。窒息新生儿无HIE组和有HIE组比较脐血S-100B蛋白浓度差异无显著性(P>0.05);12 h和24 h段差异均有显著性(P<0.05)。12 h和S-100B蛋白浓度(界值≥2.86μg/L)对判断中重度HIE有较高的特异度、灵敏度、阳性预测值和阴性预测值;1 min Apgar评分与12 h S-100B蛋白浓度之间呈负相关。【结论】血清S-100B蛋白浓度可以作为早期诊断HIE,并判断HIE严重程度的有效指标。

[Objective] To explore predictive capacity of serum S-100B protein for hypoxic-ischemic encephalopathy （HIE） after birth asphyxia. [Methods] Serum S-100B protein were examined at cord blood,12 h and 24 h after birth in 36 asphyxiated infants and 16 control infants. The concentrations of S-100B protein in serum were measured by ELISA. [Results] At every time interval there was a significant difference in serum protein S-100B concentrations between the asphyxia group and the control group （P〈0.01）. There was a significant difference in serum protein S-100B concentrations among control group, without and with HIE group at 12 h and 24 h after birth （P〈0.05）. The combination of serum protein S-100B at 12h （cutoff value≥2.86 ug/L） and Apgar score at 1 min （cutoff value≤3） had the highest positive predictive value （85.7 %）and specificity（97.6%）. [Conclusions] HIE after birth asphyxia can be predicted reliably by elevated serum concentrations of S-100B protein.