S100B蛋白及神经元特异性烯醇化酶与早产儿脑损伤关联分析

Correlation between S100B protein,neuron-specific enolase and brain damage in premature infants

目的 S100B蛋白及神经元特异性烯醇化酶(neuron-specific enolase,NSE)作为脑损伤标志物,逐渐被用于脊髓损伤和脑膜炎等神经系统疾病的诊治中,本研究旨在探讨其在早产儿脑损伤诊治中的临床应用价值。方法选取2017-02-01-2018-04-01入住郑州大学第二附属医院新生儿重症监护室胎龄<34周的早产儿56例,分别于出生后1h内、第3和天第5天采取静脉血,采用化学发光法检测S100B蛋白及NSE,根据影像学结果分为出血性脑损伤组7例、非出血性脑损伤组即脑白质软化组13例及无脑损伤组即对照组36例。结果出生后1h出血性脑损伤组的S100B蛋白水平为(0.58±0.09)ng/mL,非出血性脑损伤组为(0.96±0.14)ng/mL,显著高于无脑损伤组的(0.18±0.04)ng/mL,F=469.741,P<0.001;出生后第3天出血性脑损伤组的S100B蛋白水平为(0.48±0.09)ng/mL,非出血性脑损伤组为(0.85±0.04)ng/mL,显著高于无脑损伤组的(0.19±0.03)ng/mL,F=1 079.403,P<0.001;出生后第5天出血性脑损伤组的S100B蛋白水平为(0.43±0.10)ng/mL,非出血性脑损伤组为(0.80±0.10)ng/mL,显著高于无脑损伤组的(0.18±0.04)ng/mL,F=398.652,P<0.001;出血性脑损伤组在出生后1h的NSE水平为(69.7±16.5)ng/mL,非出血性脑损伤组在出生后1hNSE水平为(81.2±15.2)ng/mL,高于无脑损伤组的(51.8±20.9)ng/mL,差异有统计学意义,P<0.05;第3和5天差异无统计学意义,均P>0.05。结论 S100B蛋白及NSE在早产儿脑损伤时会显著升高,动态监测其水平变化可能对早产儿脑损伤的判断存在一定价值。

OBJECTIVE S100 Bprotein and neuron-specific enolase(NSE),as brain injury markers,are gradually used in the diagnosis and treatment of spinal cord injury,meningitis and other nervous system diseases.The purpose of this study is to explore their clinical value in the diagnosis and treatment of brain injury in premature infants.METHODS A total of 56 premature infants cured in the neonatal intensive care unit in Second Affiliated Hospital of Zhengzhou University with gestational age of less than 34 weeks were selected from February 1,2017 to April 1,2018.Blood samples were taken on 1 hour,3 dand 5 dafter birth.The S100 Bprotein and NSE levels in blood were detected by chemiluminescence.According to the results of iconography,all premature infants were divided into hemorrhagic brain injury group(n=7),non-hemorrhagic brain injury group(PVL group)(n=13)and no brain injury group(control group)(n=36).RESULTS The level of S100 Bprotein was(0.58±0.09)ng/ml in the hemorrhagic brain injury group at 1 hour after birth,and(0.96±0.14)ng/ml in the non-hemorrhagic brain injury group,which were significantly higher than that in the no brain injury group(0.18±0.04)ng/ml,F=469.741,P<0.001.S100 Bprotein level was(0.48±0.09)ng/ml in the hemorrhagic brain injury group on the 3 rd day after birth,and(0.85±0.04)ng/ml in the non-hemorrhagic brain injury group,which were significantly higher than that in the no brain injury group(0.19±0.03)ng/ml,F=1 079.403,P<0.001.S100 Bprotein level in the hemorrhagic brain injury group was(0.43±0.10)ng/ml on the 5 th day after birth,and(0.80±0.10)ng/ml in the non-hemorrhagic brain injury group,which were significantly higher than(0.18±0.04)ng/ml in the no brain injury group,F=398.652,P<0.001.At 1 hour after birth,the level of NSE in the hemorrhagic brain injury group was(69.7±16.5)ng/ml,and was(81.2±15.2)ng/ml in non-hemorrhagic brain injury group,which were higher than that in the control group(51.8±20.9)ng/ml,and the differences had statistical significance(P<0.05).But on the third day and fifth day after birth,there were no statistical significance in the differences(P<0.05).CONCLUSIONS S100 Bprotein and NSE are significantly elevated in premature infants with brain injury.Dynamic monitoring of changes in their levels may have some value in judging brain damage in premature infants.