血清S100B蛋白在新生儿缺氧缺血性脑病中的应用

Application of serum S100B protein in hypoxic-ischemic encephalopathy

目的探讨并分析血清S100B蛋白在新生儿缺氧缺血性脑病(HIE)中的应用及临床意义,为HIE病情及预后的评估提供临床依据。方法选取2017年1~12月我院新生儿科收治的150例HIE患儿作为试验组,按照病情轻重将其分为重度HIE组(40例),中度HIE组(50例),轻度HIE组(60例);选取同期正常新生儿60例作为对照组。不同试验组于出生后第1、3、7天留取血清标本,对照组出生后第1天留取血清标本,采用酶联免疫吸附测定(ELISA)法测定血清S100B蛋白浓度,比较各试验组及对照组之间血清S100B蛋白浓度差异。根据Gesell发育量表评估结果,将所有患儿分为有后遗症组[发育商(DQ)<85分,41例]和无后遗症组(DQ≥85分,109例),分别比较出生后第1、3、7天两组的血清S100B蛋白浓度差异。结果试验组患儿出生后第1天的血清S100B蛋白浓度均高于对照组,差异有统计学意义(P<0.05)。试验组出生后第3、7天的血清S100B蛋白浓度均高于出生后第1天,差异有统计学意义(P<0.05)。重度HIE组患儿出生后第1、3、7天的血清S100B蛋白浓度均高于中度HIE组和轻度HIE组,差异有统计学意义(P<0.05);中度HIE组患儿出生后第1、3、7天的血清S100B蛋白浓度均高于轻度HIE组,差异有统计学意义(P<0.05)。有后遗症组患儿出生后第1、3、7天的血清S100B蛋白浓度均高于无后遗症组,差异有统计学意义(P<0.01)。结论三组HIE患儿的血清S100B蛋白浓度均高于正常新生儿,且有后遗症患儿血清S100B蛋白浓度高于无后遗症患儿,因此检测血清S100B蛋白浓度有利于新生儿HIE疾病早期诊断及预后评估。

Objective To explore and analyze the application effect and clinical significance of serum S100B protein in hypoxic-ischemic encephalopathy(HIE)in neonates and provide clinical basis for the assessment of HIE condition and prognosis.Methods A total of 150 HIE children admitted to the neonatology department of our hospital from January to December 2017 were selected as the experimental group.The experimental group was divided into the severe HIE group(40 cases),the moderate HIE group(50 cases)and the mild HIE group(60 cases)according to the severity of the condition.A total of 60 normal neonates were selected as the control group.Serum samples of different groups were collected on the 1st,3rd and 7th days after birth,and serum samples of the control group were collected on the 1st day after birth.Serum S100B protein concentration was measured by enzyme-linked immunosorbent assay(ELISA),and the difference of serum S100B protein concentration between the experimental group and the control group was compared.According to the assessment results of Gesell development scale,all the HIE children were divided into the group with sequelae(41 cases)and the group without sequelae(109 cases),and the serum S100B protein concentrations of the two groups on 1st,3rd and 7th days were compared respectively.Results The serum S100B protein concentration of experimental group on the 1st day after birth was higher than that of the control group,and the difference was statistically significant(P<0.05).The serum S100B protein concentration of experimental group on the 3rd and 7th days after birth were higher than those on the 1st day,and the differences were statistically significant(P<0.05).The serum S100B protein concentration of severe HIE group on the 1st,3rd and 7th days after birth were higher than those of the moderate HIE group and the mild HIE group,and the differences were statistically significant(P<0.05).The serum S100B protein concentration of moderate HIE group on the 1st,3rd and 7th days after birth were higher than those of the mild HIE group, and the differences were statistically significant (P<0.05). The serum S100B protein concentration of group with sequelae on the 1st, 3rd and 7th days after birth were higher than those of the group without sequelae, and the differences were statistically significance (P<0.01). Conclusion Serum S100B protein concentration in HIE children is higher than that in normal neonates, and the serum S100B protein concentration of children with sequelae is higher than that of children without sequelae. Therefore, detection of serum S100B protein concentration is conducive to the early diagnosis and prognosis evaluation of neonatal HIE disease.