神经元特异性烯醇化酶及血清γ-GT在诊断新生儿胆红素脑病中的价值

The Value of Neuron Specific Enolase and Serum γ-GT in the Diagnosis of Neonatal Bilirubin Encephalopathy

目的:探究血清神经元特异性烯醇化酶(NSE)、γ-谷氨酰转肽酶(γ-GT)对新生儿胆红素脑病(NBE)的临床诊断价值。方法:选取2014年3月至2018年9月本院收治的新生儿高胆红素血症患儿340例,其中NBE患儿108例为研究组,非NBE患儿232例为对照组。观察两组血清总胆红素(TBIL)、间接胆红素(IBIL)、NSE、γ-GT水平;分析TBIL、IBIL与NSE、γ-GT的相关性;评估NSE、γ-GT及二者联合诊断NBE的价值。结果:研究组血清TBIL、IBIL、NSE、γ-GT水平均高于对照组,差异有统计学意义(P<0.05)。相关分析显示TBIL、IBIL与NSE、γ-GT水平均呈正相关(P<0.05);NSE与γ-GT亦呈正相关(P<0.05)。ROC曲线分析得出血清NSE、γ-GT及二者联合诊断的曲线下面积(AUC)分别为0.876、0.825、0.890;在最佳临界值点对应的灵敏度、特异度分别为:NSE72.2%、93.1%,γ-GT72.2%、85.3%,二者联合为82.4%、84.9%;其中二者联合的诊断效能高于单项诊断。结论:血清NSE、γ-GT对NBE均具有诊断价值,且NSE优于γ-GT,而二者联合的诊断效能最高,可为NBE早期辅助评估提供客观参考。

Objective: To investigate the clinical value of serum neuron specific enolase (NSE) and γ-glutamyltranspeptidase (γ-GT) in the diagnosis of neonatal bilirubin encephalopathy (NBE). Methods: A total of 340 children with neonatal hyperbilirubinemia admitted to our hospital from March 2014 to September 2018 were enrolled. Among them, 108 patients with NBE were in the study group and 232 patients with non-NBE were in the control group. The serum levels of total bilirubin (TBIL), indirect bilirubin (IBIL), NSE, and γ-GT were observed. To analyze the correlation between TBIL, IBIL and NSE,γ-GT;to evaluate the value of NSE,γ-GT and their combined diagnosis of NBE. Results: The serum levels of TBIL, IBIL, NSE and γ-GT in the study group were higher than those in the control group, and the difference was statistically significant (P<0.05). Correlation analysis showed that TBIL and IBIL were positively correlated with NSE and γ-GT levels (P<0.05);NSE was also positively correlated with γ-GT (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum NSE,γ-GT and the combined diagnosis of the two were 0.876, 0.825, 0.890;The sensitivity and specificity corresponding to the optimal threshold point were: NSE 72.2%, 93.1%,γ-GT 72.2%, 85.3%, and the combined diagnosis was 82.4% and 84.9%;The combined diagnostic efficacy of the two is higher than the single diagnosis. Conclusion: Serum NSE and γ-GT have diagnostic value for NBE, and NSE is superior to γ-GT, and the combination of the two has the highest diagnostic efficiency, which can provide an objective reference for early auxiliary evaluation of NBE.