选择性头部降温对缺氧缺血性脑病新生儿血清NSE的影响

EFFECT OF SELECTIVE HEAD MILD HYPOTHERMIA ON THE LEVEL OF NSE OF NEWBORN WITH HYPOXIC ISCHEMIC ENCEPHALOPATHY

目的:探讨选择性头部亚低温治疗对缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)新生儿血清神经元特异性烯醇化酶(neuron specific enolase,NSE)的影响。方法:将40例中重度HIE患儿随机分为选择性头部亚低温治疗组(亚低温组)和常规治疗对照组(治疗对照组)各20例。二组均采用常规治疗,亚低温组出生6h内采用选择性头部降温方法,维持鼻咽部温度(34.0±0.5)℃,肛温(35.5±0.5)℃,持续72h。并以20例正常足月新生儿做为正常对照组,采用放射免疫分析法,检测生后3天血清NSE水平。采用独立样本t检验进行统计学分析。结果:亚低温组和治疗对照组患儿NSE水平明显高于正常对照组;治疗后亚低温组NSE水平显著低于治疗对照组。结论:NSE水平是反映脑组织损伤的较好的生化指标,临床上早期用亚低温治疗中、重度HIE有较好的疗效。

Objective：To explore the effect of selective head mild hypothermia on the level of NSE of newborn with hypoxic ischemic encephalopathy. Methods：Forty neonates with moderate or severe HIE were randomly assigned into selective head mild hypothermia treatment group （n=20）and routine treatment group （n=20）.Selective head mild hypothermia was used within 6 hours after birth to keep nasopharyngeal temperature at（34.0±0.5）℃ and rectal temperature at（35.5±0.5）℃ for 72 hours in mild hypothermia treatment group.At the same time , 20 cases of normal neonate were selected as the normal control group. Results：The level of NSE in mild hypothermia group and the routine treatment group were significantly higher than that in the normal control group. However , after selective head mild hypothermia treatment , the level of NSE in the mild hypothermia group were lower than that in the routine treatment group. Conclusion：The concentration of NSE in serum can be used as an index for appraising the brain injure severity of HIE , selective head mild hypothermia has protective effect on the patient with HIE.