血清神经元特异性烯醇化酶、S100B蛋白、肌酸激酶和羧丁酸脱氢酶水平对宫内感染早产儿脑损伤的早期诊断价值

Diagnostic value of serum NSE,S100B protein and myocardial zymogram in premature infants with intrau-terine infection

目的 探讨血清神经元特异性烯醇化酶(NSE)、S100B蛋白、肌酸激酶(CK)和羧丁酸脱氢酶(HBDH)水平对宫内感染早产儿脑损伤的诊断价值.方法 选择温州市中西医结合医院2016 年1 月至2017年12月诊治的宫内感染早产儿60例为研究对象,根据是否发生脑损伤分为脑损伤组28例与非脑损伤组32例.采用化学发光法检测血清NSE含量,采用酶联免疫吸附试验法(ELISA)检测血清S100B蛋白,采用全自动生化分析仪检测血清CK和HBDH水平.比较两组血清NSE、S100B、CK和HBDH水平,评估NSE+S100B蛋白+CK+HBDH联合诊断效能,分析血清NSE、S100B蛋白、CK和HBDH与脑损伤的相关性.结果脑损伤组血清NSE[(2.43 ± 0.54)μg/L]和 S100B[(14.36 ± 3.21)ng/L]水平高于非脑损伤组[(0.97 ± 0.27)μg/L]和[(8.10 ± 1.87)ng/L],差异均有统计学意义(t=13.498、9.370,均P<0.05).脑损伤组血清CK[(437.64 ± 54.12)U/L]和HBDH[(387.91 ± 56.45)U/L]水平高于非脑损伤组[(183.54 ± 32.58)U/L]和[(174.32 ± 26.63)U/L],差异均有统计学意义(t=22.347、19.126,均P<0.05).NSE+S100B蛋白+心肌酶谱联合诊断宫内感染早产儿脑损伤灵敏度和特异度高于各单项指标.血清NSE、S100B蛋白、CK和HBDH与脑损伤呈线性正相关.结论 宫内感染早产儿出生后血清NSE、S100B蛋白和心肌酶谱水平的升高作为判断是否发生脑损伤具有一定的临床意义.

Objective To explore the diagnostic value of serum NSE,S100B protein and myocardial zymogram in premature infants with intrauterine infection.Methods From January 2016 to December 2017,60 preterm infants with intrauterine infection in the Integrated Chinese and Western Medicine Hospital of Wenzhou were selected in the study.According to whether brain injury occurred,they were divided into brain injury group(28 cases)and non-brain injury group(32 cases).Serum NSE content was detected by chemiluminescence method,serum S100B protein level was detected by enzyme linked immunosorbent assay(ELISA),and serum CK and HBDH levels were detected by automatic biochemical analyzer.The serum levels of NSE,S100B,CK and HBDH were compared between the two groups,the combined diagnostic efficacy of NSE+S100B protein+CK+HBDH was analyzed,the correlation of serum NSE,S100B protein,CK,HBDH with brain injury wasanalyzed.Results The levels of serum NSE [(2.43 ± 0.54)μg/L] and S 100B [(14.36 ± 3.21)ng/L] in the brain injury group were higher than those in the non-brain injury group [(0.97 ± 0.27)μg/L and(8.10 ± 1.87)ng/L](t =13.498,9.370,all P <0.05).The levels of serum CK [(437.64 ± 54.12)U/L] and HBDH [(387.91 ± 56.45)U/L] in the brain injury group were signifi-cantly higher than those in the non-brain injury group [(183.54 ± 32.58)U/L and(174.3 ± 26.63)U/L](t=22.347,19.126,all P<0.05).The sensitivity and specificity of the combined diagnosis of NSE+S100B protein and myocardial zymogram were higher than those of each single index.Serum NSE,S100B protein,CK and HBDH were positively correlated with brain injury.Conclusion The elevation of serum NSE,S100B protein and myocardial zymogram in preterm infants with intrauterine infection after birth has certain clinical significance in judging whether brain injury occurs or not.