摘要
目的:分析血清神经元特异性烯醇化酶(NSE)的动态浓度与新生儿缺氧缺血性脑病(HIE)不同时期临床特点的相关性。方法 :以新生儿HIE患儿107例按2005年新生儿缺血缺氧性脑病诊断标准分为HIE轻、中、重度3个亚组,同期入室新生儿30例为对照组,分别动态血清NSE定量检测,观察记录新生儿HIE病例的临床症状资料进行统计学分析。结果:中、重度亚组血清NSE水平明显高于对照组与轻度HIE亚组,差异有统计学意义(P<0.05)。血清NSE与NBNA变化水平显著负相关(P=0.000),与血清NSE浓度升高具统计学意义的临床表现有:兴奋与抑制的意识状态、肌张力下降或强直、吸吮反射消失、瞳孔不等和/或对光反射迟钝等。死亡患儿血清NSE浓度变化明显高于存活组,差异有统计学意义(P<0.05)。出现后遗症病例HIE急性期NSE浓度高于无后遗症组水平,差异有统计学意义(P<0.05)。结论 :血清NSE浓度是反映新生儿HIE严重程度的敏感生化指标,NSE浓度变化趋势是新生儿HIE预后评估的有效指标之一。
Objective: To analyze the correlation between dynamic concentration of serum neuron - specific enolase (NSE) and clinical characteristics of neonatal hypoxic -ischemic encephalopathy (HIE) during different periods. Methods: One hundred and seven ne- onates with HIE were divided into mild HIE subgroup, moderate HIE subgroup, and severe HIE subgroup according to neonatal HIE diagnos- tic criteria formulated in 2005, thirty neonates who went to the hospital during the same period were selected as control group; dynamic serum neuron - specific enolase quantitative determination was perdormed, the clinical symptoms of neonates with HIE were observed and recorded, then the data were analyzed statistically. Results: The levels of serum neuron - specific enolase in moderate HIE subgroup and severe HIE subgroup were statistically significantly higher than those in control group and mild HIE subgroup ( P 〈 0.05 ) . There was a significantly negative correlation between serum neuron - specific enolase and change of NBNA level (P = 0. 000), the clinical manifestations which were significantly correlated with increase of serum neuron - specific enolase concentration included : conscious states of exciting and suppression, decrease or rigidity of muscular tension, disappear of sucking reflex, anisocoria and/or bluntness of light reflex. The concentration of serum NSE in death group was statistically significantly higher than that in survival group (P 〈 0.05) . The concentration of neuron - specific eno- lase during acute phase in patients with sequela was statistically significantly higher than that in patients without sequela ( P 〈 0. 05 ) Conclusion: Serum neuron - specific enolase concentration is a sensitive biochemical indicator to reflect severity of neonatal HIE, change trend of NSE concentration is one of effective assessment indicator of prognosis of neonates with HIE.
出处
《中国妇幼保健》
CAS
北大核心
2013年第15期2402-2407,共6页
Maternal and Child Health Care of China
基金
广东省卫生厅项目〔A2006536〕