生物标记物对脑损伤患儿早期诊断及监测价值的研究进展

Research Progress of Biomarkers in Early Diagnosis and Monitoring in Newborn with Brain Injury

脑损伤是新生儿期危害严重的疾病之一,可导致脑瘫、运动发育迟缓、认知功能障碍及学习困难等后遗症,严重影响了新生儿的健康发育及生活质量的提高。新生儿脑损伤(NBI)是一种由多种原因导致的范围很广的疾病,其临床表现缺乏特异性,临床上在判断其损伤严重程度、持续时间及产前损伤时间等存在较大的困难,受到广大科研者及临床医师的重视。目前,影像学方法是NBI确诊的主要手段,但影像学检查通常存在滞后性和一定的局限性。体液生物标记物水平在脑损伤后会较早发生变化,通过检测其水平变化可早期预测脑损伤情况。近年来,新生儿各种体液中已检测出多种具有敏感性的脑损伤生物标记物,主要包括神经元特异性烯醇化酶(NSE)、泛素羟基末端水解酶L-1(UCH-L1)、S100B蛋白、Tau蛋白、髓鞘碱性蛋白(MBP)、胶质纤维酸性蛋白(GFAP)、激活素A等,本研究对上述常用生物标记物在NBI中的应用情况以及研究进展进行综述,探讨其临床应用前景。

Brain injury is one of the most serious diseases in neonatal period,which can cause cerebral palsy,motor development delay,cognitive dysfunction and learning difficulties and other sequelae,and severely affects the health development and quality of life of the newborn.Neonatal brain injury（NBI） is a wide range of diseases caused by a variety of causes,its clinical manifestations lack specificity,clinically,it is difficult to judge the severity,duration and the time of prenatal injury,and it has been paid much attention to by scientific researchers and clinicians.At present,imaging method is a major means of NBI diagnosis,but imaging examination is usually a lag and limitations.Levels of humoral biomarkers change early after brain injury,and early brain injury can be predicted by detecting their changes.In recent years,a variety of sensitive brain damage biomarkers have been detected in various body fluids of newborns,mainly including neuron-specific enolase（NSE）,ubiquitin carboxyl hydrolase L1（UCH L1）,S100 B protein,tau protein,myelin basic protein（MBP）,glial fibrillary acidic protein（GFAP） and activin A and so on.the application and research progress of these commonly used biomarkers in NBI are reviewed in this paper.