sCLU蛋白、S100B和NSE在早产儿脑损伤早期诊断中的应用价值

Clinical Application Value of sCLU Protein,S100B and NSE in Early Diagnosis of Brain Injury in Premature Infants

目的:探讨血清分泌型丛生蛋白(sCLU)、S100钙结合蛋白B(S100B)及神经元特异性烯醇化酶(NSE)在早产儿脑损伤(BIPI)早期诊断中的应用价值。方法:选择2018-08—2020-10在泰兴市人民医院住院治疗的98例早产儿作为研究对象,早产儿脑损伤48例作为脑损伤组,早产儿无脑损伤50例为对照组,所有患儿分别于生后1h、12h、3天采集静脉血测定血清sCLU、S-100B蛋白、NSE浓度,通过ROC曲线评价各项指标对早产儿脑损伤的早期诊断效能。结果:脑损伤组患儿出生后1h和12h sCLU、S100B水平均高于对照组,差异有统计学意义(P均<0.01)。脑损伤组:与出生后1h比较,出生后12h sCLU水平升高(P<0.01),出生后3天sCLU水平降低(P<0.01);与出生后12h比较,出生后3天sCLU水平降低(P<0.01)。与出生后1h和12h比较,出生后3天S100B水平降低(P<0.01)。脑损伤组出生后1h、12h,3天NSE水平均高于对照组,差异有统计学意义(P均<0.01)。脑损伤组与出生后1h比较,出生后12h和3天NSE水平均升高(P<0.01)。出生后12h(sCLU+NSE)联合检测对早产儿脑损伤具有较高诊断价值,其敏感度和特异度分别为91.60%、97.10%,AUC值也是最大的为0.926。结论:脑损伤早产儿血清中sCLU、S100B、NSE水平呈动态变化,sCLU、NSE联合检测对BIPI具有较好的的诊断价值。

Objective:To explore the application value of serum clusterin(sCLU),S100 calcium binding protein B(S100B)and neuron specific enolase(NSE)in early diagnosis of brain injury in premature infants.Method:98 premature infants from August 2018 to October 2020 were selected as the research objects,and 48 premature infants with brain injury were selected as brain injury group,while 50 premature infants without brain injury were taken as control group.Venous blood was collected from all cases at 1h,12h and 3 days after birth to measure the concentration of serum sCLU,S100B protein and NSE,and the early diagnostic efficacy of each index for brain injury of premature infants was evaluated by ROC curve.Results:The levels of sCLU and S100B in brain injury group were higher than those in control group at 1h and 12h after birth,and the difference was statistically significant(P<0.01).In brain injury group compared with one hour after birth,sCLU level was increased at 12 hours after birth(P<0.01),and decreased at 3 days after birth(P<0.01).Compared with 12 hours after birth,the level of sCLU was decreased 3 days after birth(P<0.01).Compared with one hour after birth and 12 hours after birth,the level of S100B was decreased at 3 days after birth(P<0.01).The levels of NSE in children with brain injury group were higher than those in control group at 1h,12h and 3 days after birth,The difference was statistically significant(P<0.01).Compared with 1 hour after birth,NSE level was increased at 12 hours and 3 days after birth(P<0.01).The model also demonstrated the highest specificity(96.20%)at the cutoff value of 5.82ng/ml of S100B at 1 hour after birth.The sensitivity and specificity of combined detection of sCLU and NSE at 12 hours after birth were 91.60%and 97.10%respectively,with the highest AUC value of 0.926.Conclusion:The levels of sCLU,S100B and NSE were dgnamic changes in the serum of premature infants with brain injury.The combined detection of sCLU and NSE turned out to be a good diagnostic marker for premature infants with brain injury.