高胆红素血症足月新生儿血清NSE临床分析

目的分析不同日龄及不同程度高胆红素血症足月新生儿血清神经元特异性烯醇化酶（NSE）水平的变化。方法选择2015年9月至2016年1月因高胆红素血症住院的足月新生儿共192例。入院当天进行第一次采血检测血清NSE、总胆红素、间接胆红素，根据黄疸程度给予光疗及益生菌等退黄治疗；纳入病例在第一次采afiT-72h后进行第二次采血检测NSE。分别比较分析在相同日龄、不同胆红素水平以及相同胆红素水平、不同日龄两组中各亚组NsE有无差异。结果相同日龄范围内，血清NSE1水平随着胆红素的升高而升高，NSE1在A1与A3、B1与B3、B2与B3之间差异具有统计学意义（P〈0．05），NSE2在两组中各亚组之间差异均无统计学意义（P〉0．05）。在相同胆红素水平，NSE1在轻中度胆红素水平随日龄增加而降低，在重度胆红素水平，NSE1随日龄增加明显升高，且二者差异具有统计学意义（P〈0．05）；NSE2则随日龄增加而降低，且在各对应亚组差异具有统计学意义（P〈0．05）。结论高胆红素血症足月新生儿血清NSE水平随日龄及胆红素程度存在不同的变化，在早期预测胆红素脑损伤具有一定的价值。

Objective To analyze the change in serum NSE of full-term neonates with hyperbilirubinemia in varying degrees and different ages. Methods A total of 192 full-term neonates hospitalized for hyperbilirubinemia between September 2015 and January 2016 were selected. The blood serum NSE, total bilirubin, indirect bilirubin were measured for the first time on the day of admission according to the degree of jaundice phototherapy and given probiotics treatment; blood samples were collected to detect NSE in the first 72h after blood sampling. The differences of NSE were compared between the two groups at the same age, different bilirubin levels, the same bilirubin level and different age. Results The same age range, the serum level of NSE 1 increased with the increase of bilirubin, NSE1 had a statistically significant difference between A1 and A3, B 1 and B3, B2 and B3 （ P〈0.05 ） , NSE2 in the two groups between sub groups showed no significant difference （ P〉0.05 ） . In the same level of bilirubin, NSE1 in mild to moderate levels of bilirubin decreased with the increase of age, the severe level of bilirubin. NSE 1 increased significantly with the increase of age, and there was a significant difference between the two NSE2 （ P〈0.05 ） ; with the increase of age decreased, and there was statistical significance in each corresponding subgroup differences （ P〈0.05 ） . Conclusion The level of serum NSE of full-term neonates with hyperbilirubinemia varies with the age in days and the degree of bilirubin, which is of a certain significance to the early prediction of bilirubin cerebral injury.