s-NSE对早期判断新生儿急性胆红素脑病的意义

SIGNIFICANCE OF SERUM NEURON SPECIFIC ENOLASE IN THE EARLY DIAGNOSIS OF ACUTE BILIRUBIN ENCEPHALOPATHY IN NEONATES

目的探讨血清神经元特异性烯醇化酶(s-NSE)能否作为早期判断急性胆红素脑病(ABE)的生物学指标。方法选择高胆红素血症病儿63例,以24例同期出生的生理性黄疸不明显的足月新生儿作为对照组,测定两组血清总胆红素(TSB)水平,采用电化学发光免疫法测定s-NSE水平。结果不同高胆红素水平的各组s-NSE水平比较差异有统计学意义(F=59.813,P<0.01),足月儿s-NSE水平与TSB水平间呈显著正相关(r=0.762,P<0.01);早产儿组s-NSE水平显著高于同等高胆红素水平的足月儿组(F=56.287,q=2.84,P<0.05)。结论高胆红素血症病儿s-NSE水平显著升高,升高程度与TSB水平和早产因素相关。s-NSE较TSB更有可能成为敏感的判断ABE的生物学指标。

Objective To explore whether serum neuro specific enolase （s-NSE） can be used as a biological indicator for an early diagnosis of acute bilirubin encephalopathy （ABE） in neonates. Methods Sixty three neonates with hyperbilirubinemia and 24 full term newborns without physiologic iaundice were recruited in this study, the latter was served as controls. The levels of s-NSE were determined by elcctrochemiluminescence, and total serum bilirubin （TSB） detected. Results There were significant differences in the level of s-NSE among different hyperbilirubinemia babies （F=59. 813,P〈0.01）. The level of s-NSE was positively correlated with TSB in full-term newborns （r= 0. 762,P〈0.01）. In premature group, the level of s-NSE was significantly higher than that in the full term with same-level hyperbilirubinemia （F=56. 287;q=2.84;P〈0.05）. Conclusion The serum level of s-NSE is significantly increased in neonates with hyperbilirubinemia, which is associated with the level of TSB as well as with maturity of the neonates. The s-NSE is more likely than TSB to become a sensitive indicator for early diagnosis of ABE.