236例S100B联合NSE检测用于足月新生儿HIE病程早期观察

Early observing HIE pathogenesis of 236 full-term neonates by S100B test combined with NSE test

目的:探讨血清学标志物S100B联合NSE检测在足月新生儿HIE疾病的早期诊断和监测中的价值,为临床诊治提供更多补充性依据。方法:以2009年7月～2011年7月收治的236例足月新生儿HIE患者为研究对象,选择同期出生的236例足月健康新生儿为对照组,应用电化学发光法监测HIE患者病程早期(入组后第1天、第3～5天,第7～10天)的血清S100B和NSE水平。结果:HIE组血清S100B和NSE水平显著高于对照组,各观察点P<0.05;第3～5天除轻度组外,S100B和NSE分别在重度组、中度组和重度组有显著性上升,均P<0.05。治疗前后(第7～10天对比第1天)S100B和NSE在各组均有显著性降低,P<0.05;轻度组在初步治疗后S100B和NSE基本上能恢复正常,与健康对照组无显著性差异,P>0.05,其他组仍然显著高于对照组,P<0.05;S100B和NSE相关性较好,r=0.950,P>0.05。结论:血清S100B和NSE联合检测是足月新生儿HIE疾病早期监测和辅助诊断的合理模式,有助于为临床诊治提供更多补充性证据。

Objective：To explore the value of S100B test combined with neuron-specific enolase（NSE） test for early diagnosis and monitoring of hypoxic-ischemic encephalopathy（HIE） in full-term neonates,and provide more complementary evidences for clinical diagnosis and treatment of HIE. Methods：A total of 236 full-term neonates with HIE who were treated in the hospital from July 2009 to July 2011 were selected as study objects,and 236 healthy full-term neonates who were born during the same period were selected as control group,electrochemiluminescence was used to monitor the serum levels of S100B and NSE during early course of the disease（at one day,3-5 days,and 7-10 days after grouping）. Results：The serum levels of S100B and NSE in HIE group were statistically significantly higher than those in control group at different time points（P〈0.05）;at 3-5 days after grouping,except mild group,the serum levels of S100B in severe group and NSE in moderate group and severe group increased significantly（P〈0.05）.There was statistically significant difference in the serum levels of S100B and NSE between before and after treatment（P〈0.05）.In mild group,the serum levels of S100B and NSE basically returned to normal after primary treatment,compared with control group,there was no statistically significant difference（P〉0.05）,but the serum levels of S100B and NSE in the other groups were still statistically significantly higher than those in control group（P〈0.05）.There was a good correlation between S100B and NSE（γ=0.950,P〉0.05）. Conclusion：Joint test of S100B and NSE is a reasonable mode for early monitoring and assistant diagnosis of full-term infants with HIE,which is helpful to supply more complementary evidences for clinical diagnosis and treatment.