血清神经元特异性烯醇化酶缺血修饰蛋白与新生儿缺氧缺血性脑病严重程度的相关性分析

Correlationanalysis of serum neuron-specific enolase and ischemia-modified albumin with severity of neonatal hypoxic-ischemic encephalopathy

目的探讨血清神经元特异性烯醇化酶(NSE)、缺血修饰蛋白(IMA)与新生儿缺氧缺血性脑病(HIE)病情严重程度的关系。方法选择2016年3月至2017年2月潮州市中心医院新生儿科收治的81例HIE患儿作为HIE组,根据病情轻重,将HIE组分为轻度HIE组32例、中度HIE组24例及重度HIE组25例;选择同期30例正常足月新生儿作为对照组。分别检测对照组生后1~2 d及3组患者HIE急性期与恢复期血清NSE、IMA水平,分析两者与HIE病情严重程度的关系。采用Pearson相关分析,分析三组HIE急性期及恢复期NSE、IMA的相关性。结果 3组HIE急性期及恢复期NSE、IMA均高于对照组,差异有统计学意义(P<0.05)。其中重度HIE组急性期NSE、IMA[(61.14±30.8)μg/L,(97.26±2.46)U/mL]高于中度HIE组[(40.30±10.81)μg/L,(93.08±1.90)U/mL]及轻度HIE组[(18.75±1.40)μg/L,(83.75±0.78)U/mL],差异均有统计学意义(P<0.05)。恢复期重度HIE组NSE,IMA[(20.81±9.57)μg/L,(83.34±2.01)U/mL]及中度HIE组[(21.14±7.04)μg/L,(82.28±2.17)U/mL]均高于轻度HIE组[(10.89±5.14)μg/L,(73.17±1.91)U/mL],差异均有统计学意义(P<0.05)。Pearson相关性显示,三组患者HIE急性期,恢复期NSE与IMA均呈正相关(P<0.05)。结论血清NSE与IMA水平的变化与HIE病情严重程度正相关。

ObjectiveTo investigate the correlation between serum levels of neuron-specific enolase(NSE)andischemia-modified albumin(IMA)and severity of neonatal hypoxic-ischemic encephalopathy(HIE).Methods81cases of HIE children treated in our hospital from Mar2016to Feb2017were enrolled as the HIE group,and basing on severity of illness,they were further divided into three subgroups,32cases of mild subgroup,24cases of moderate subgroup and25cases of severe subgroup.Other30cases of normal full-term newbornswere collected simultaneously as the control group.The serum levels of NSE and IMA at1~2days after birth in the control group and the NSE and IMA levelsin the acute and convalescentstages in the3HIE subgroups were detectedrespectively,and theirrelationship with severity of HIE illness were thenanalyzed.The relativityof NSE and IMA levels in the acute and convalescent stages in the three HIE subgroups wereevaluatedby Pearson correlation analysis.ResultsThe NSE and IMA levels in the acute and convalescentstagesinthe three HIEsubgroups were all significantlyhigher than those in the control group[(5.87±4.25)μg/L,(70.92±2.67)U/ml;P<0.05].Among them,the NSE and IMA levels inthe acute stagein the severesubgroup[(61.14±30.8)μg/L,(97.26±2.46)U/mL]were significantly higher than those in the moderate subgroup[(40.30±10.81)μg/L,(93.08±1.90)U/mL]and mild subgroup[(18.75±1.40)μg/L,(83.75±0.78)U/mL](all P<0.05).In the convalescent stage,the NSE and IMA levels in the severe subgroup[(20.81±9.57)μg/L,(83.34±2.01)U/mL]and moderate subgroup[(21.14±7.04)μg/L,(82.28±2.17)U/mL]were allhigher than those in the mild subgroup[(10.89±5.14)μg/L,(73.17±1.91)U/mL],with significant differences(P<0.001).Pearson correlation analysis showed that there had positive correlation betweenthe NSE and IMA levels in the acute stage and the convalescent stage inall subgroups.ConclusionChanges of serum NSE and IMA levelsarepositivelycorrelated with the HIE severityand could sensitively reflect the severity of HIE neonates.