神经元特异性烯醇化酶的浓度变化对新生儿缺氧缺血性脑病的诊断价值研究

Diganostic value of neuron-specific enolas concentration for neonatal hypoxic ischemic encephalopathy

目的探讨血液中神经元特异性烯醇化酶（NSE）的浓度变化对新生儿缺氧缺血性脑病（HIE）的诊断价值。方法收集2012年1月~2015年6月我院收治的60例HIE患儿,按临床症状的诊断标准将其分为轻度组（23例）、中度组（20例）、重度组（17例）;同时分为出生窒息组和宫内窘迫组,各30例;另外选取本院同期的20例健康新生儿为对照组。检测各组血液中的NSE浓度,并分析脑损伤状况与NSE的关联性。结果治疗前,轻度、中度、重度组的血清NSE浓度均高于对照组,差异有统计学意义（P〈0.05）。治疗后,轻度组的NSE浓度与对照组接近,差异无统计学意义（P〉0.05）;中度组和重度组的NSE浓度仍高于对照组,差异有统计学意义（P〈0.05）。治疗前后,出生窒息组和宫内窘迫组的血清NSE浓度均高于对照组（P〈0.05）。结论不同原因导致缺氧缺血性脑损伤的新生儿的血液NSE浓度均高于正常健康新生儿群体,并且NSE浓度会随着脑损伤程度的加重而相应升高,因此血清NSE可作为临床上诊治HIE的重要参考指标。

Objective To investigate the diganostic value of neuron-specific enolas（NSE） concentration in blood for the neonatal hypoxic ischemic encephalopathy（HIE）. Methods 60 cases of neonates with HIE in our hospital from January 2012 to June 2015 were selected.According to the diagnostic criteria with clinical symptoms,they were divided into mild group（23 cases）,moderate group（20 cases） and severe group（17 cases）.At the same time,they were divided into the asphyxia group and the intrauterine distress group, with 30 cases in each group. 20 healthy newborns in the same period of our hospital were selected as the control group.The serum NSE level in every group was detected,and the relationship between brain damage and NSE was analyzed. Results Before treatment,the serum NSE level in mild,moderate and severe groups was higher than that of control group,the difference was statistically significant（P 〈0.05）.After treatment,the serum NSE level in mild group was similar to that of control group,the difference was no statistically significant（P〉0.05）. Before and after treatment,the serum NSE level in moderate and severe group was higher than that of control group,the difference was statistically significant（P 〈0.05）.Before and after treatment,the serum NSE level in asphyxia group and intrauterine distress group was higher than that of control group（P〈0.05）. Conclusion The neonates with hypoxic ischemic brain damage caused by different reasons have a higher serum NSE level than the normal healthy newborns,which also increase by the severity of brain damage aggravating.NSE can be used as an important reference for the clinical diagnosis.