新生儿缺氧缺血性脑病血清S-100B蛋白与NBNA评分动态监测的临床研究

Clinical study of dynamic monitoring of serum S-100B protein levels in newborns with hypoxic ischemic encephalopathy

目的:观察新生儿缺氧缺血性脑病(hypoxic-ischemicencephalopathy,HIE)血清S-100B蛋白的动态变化规律,探讨其在HIE早期诊断中的价值,以及其浓度变化与病情严重程度及预后的关系。同时研究围产期高危因素以及NBNA评分在HIE发生发展与预后中的作用。方法:30例住院正常新生儿作为对照组,于出生后采血,55例HIE患儿(HIE组)分别于出生后1天、2天、7天采血,采用酶联免疫吸附试验、双抗体夹心法检测。收集并分析两组围产期相关资料。HIE组并于采血同时进行NBNA评分。结果:(1)HIE患儿生后第一天与第二天血清S-100B蛋白浓度明显高于对照组(P<0.05),生后第七天轻度HIE与对照组比较没有统计意义,中、重度HIE与对照组比较有统计学意义。(2)生后第一天与第二天不同病情组HIE患儿NBNA评分相互比较差异具有统计学意义(P<0.05),第七天轻、中和重度患儿NBNA评分<35分的患儿分别占33.3%,47.1%,100%。结论:动态监测HIE患儿血清S-100B蛋白浓度和NBNA评分的变化,对HIE的早期诊断,严重程度的判断以及预后的估计有重要意义。

Objective：To investigate the clinical value of S-100B and NBNA score on neonatal with hypoxic ischemic encephalopathy（HIE） in early judgment and prognosis,and to study the clinica1 significance of perinatal stage high risk factor.Methods：30 cases of normal neonates as control group,The serum S-100B concentrations were detected in 55 asphyxia newborn at 1st day,2nd days and 7th days after birth.Carrying out NBNA score.at the same time.S-100 protein was measured dynamically by ELASA.Collectting and analyzing perinatal stage correlated information.Results：（1） The levels of serum S-100B in newborns with HIE were obviously higher than that in control group at 1st day and 2nd days（P〈0.05）,No significant differences were observed in the slight pathologyical change group as compared with the levels of control group at 7th days（P〉0.05）.（2） To compare NBNA score in newborns with HIE,there was still significantly different between the different pathogenetic condition at 1st day and 2nd days（P〈0.05）.At 7th days,NBNA score〈35 was 33.3%,47.1%,100%.Conclusion：It is important for early diagnosis and determination of the severity and prognosis of HIE to monitor serum S-100B protein levels and NBNA score.