神经元特异性烯醇化酶浓度变化与高胆红素血症后遗症的关系探究

The clinical Significance of the Serum Neurone Specific Enolase Level in Bilirubin encephalopathy

目的:探讨血清神经特异性烯醇化酶(NSE)在新生儿中-重度高胆红素血症中的浓度变化情况,并进一步探讨血清NSE水平在胆红素脑病诊治中的临床意义。方法:选取151例中-重度新生儿高胆红素血症患儿为研究对象,均测定血清NSE水平,中-重度黄疸患儿以血清NSE水平分为三组,A组为血清NSE≥36 ng/ml,共31例;B组为血清NSE<36 ng/ml,且≥18 ng/ml;C组血清NSE<18 ng/ml。结果:在视力受损、脑干诱发电位异常、语言发育落后、运动发育迟滞、NBNA评分异常、头颅MRI异常发生率方面A、B、C组比较差异有统计学意义(P<0.05),且呈正相关,而在癫痫发作发面比较,差异无统计学意义(P>0.05)。结论:血清神经特异性烯醇化酶(NSE)水平是新生儿胆红素性脑病的重要标志物,可作为早期诊断及判断预后的指标。

Objective To determine the concentration of serum neuron pecific enolase（ NSE） as a specific marker of nerve injury in neonatol with Bilirubin encephalopathy and study clinical significance of NSE. Method 151 pedatric patients with high level of Bilirubin were selected and divided into three groups： A group patients with the level of NSE ≥36 ng/ml concluded 31 persents; B group concluded 48 patients who had the level of NSE 36 ng/ml,and ≥ 18 ng/ml,C Group was composed by the patients with the level of NSE 18 ng/ml. Results There were significant difference in the former three kings（ A,B,and C group） of the incidence of abnormal vision,Auditory brainstem response（ ABR）,development of language and athletics,Neonatal Behavioral Neurological Assessment（ NBNA）,and Brain MRI（ P〈0. 05）,There was no difference of the incidence of Epilepsy among three groups（ P〉0. 05）. Conclusion The levels of NSE are closely correlated with severity of Bilirubin encephalopathy. Serum NSE maybe used as a promising marker for diagnosis and evaluating severity of Bilirubin encephalopathy.