宫内发育迟缓儿羊水及脐血中神经元特异性烯醇化酶(NSE)水平测定对筛查脑损伤意义的研究

Research on significance of neuron specific enolase detection in amniotic fluid and umbilical cord blood of infants with intrauterine growth retardation in screening of brain injury

目的:探讨宫内发育迟缓儿(IUGR)羊水及脐血中神经元特异性烯醇化酶(NSE)的水平变化及与脑损伤的关系。方法:选择2006年1月～2008年12月间在宜春市人民医院出生的IUGR共83例为研究组,按出生时1min Apgar评分分为2组:窒息IUGR组(1min Apgar≤7分,48例)及非窒息IUGR组(1min Apgar≥8分,35例)。另设40例正常适于胎龄儿(AGA)为健康对照组。各组均在新生儿娩出时立即抽取羊水及脐血,采用酶联免疫吸附法(ELISA)测定NSE水平,并分别与健康对照组比较。结果:与健康对照组羊水NSE(10.3±5.9)μg/L,脐血NSE(13.5±7.4)μg/L相比,非窒息IUGR组羊水NSE水平(12.8±7.7)μg/L,无明显增高(P>0.05),脐血NSE水平(18.4±9.2)μg/L,则有所增高(P<0.05);而窒息IUGR组羊水NSE水平(16.6±8.4)μg/L,有所增高(P<0.05),脐血NSE水平(30.6±13.1)μg/L,则显著升高(P<0.01)。窒息程度越重,NSE水平越高。结论:NSE水平与脑损伤有关,IUGR脐血NSE水平增高明显,脐血水平增高对筛查IUGR脑损伤存在指导意义,若有异常可开展早期干预。

Objective：To explore the relationship between changes of neuron specific enolase （NSE） levels in amniotic fluid and umbilical cord blood of infants with intrauterine growth retardation （IUGR） and brain injury.Methods：83 infants with IUGR born in People＇s Hospital of Yichun from January 2006 to December 2008 were selected as study group and divided into asphyxia IUGR group （1 minute Apgar score≤7, 48 cases） and non-asphyxia IUGR group （1 minute Apgar score≥8, 35 cases） according to 1 minute Apgar score at birth, 40 normal infants of appropriate for gestational age （AGA） were selected as control group, samples of amniotic fluid and umbilical cord blood were extracted from all the infants at birth, NSE level was detected by enzyme linked immunosorbent assay （ELISA）, then the results were compared to those of control group.Results：There was no significant difference in NSE level in amniotic fluid between control group （10.3±5.9） μg/L and non-asphyxia IUGR group （12.8±7.7）μg/L （P0.05）, the NSE level in umbilical cord blood of non-asphyxia IUGR group （18.4±9.2）μg/L was significantly higher than that of control group （13.5±7.4）μg/L （P0.05）; while in asphyxia IUGR group, the NSE levels in amniotic fluid （16.6±8.4）μg/L and umbilical cord blood （30.6±13.1）μg/L increased significantly （P0.05） （P0.01）, the NSE levels increased with the degree of asphyxia.Conclusion：The NSE level is related to brain injury, the NSE level in umbilical cord blood of infants with IUGR increases significantly, increase of NSE level in umbilical cord blood has a directive significance in screening of brain injury of infants with IUGR, early intervention may be conducted if abnormality is found.