新生儿胆红素脑病的诊断与血清神经元特异性烯醇化酶、γ-谷氨酰转肽酶的相关性分析

Correlation analysis between the diagnosis of neonatal bilirubin encephalopathy and serum neuron-specific enolase andγ-glutamyl transpeptidase

目的探讨新生儿胆红素脑病(NBE)血清神经元特异性烯醇化酶(NSE)、γ-谷氨酰转肽酶(γ-GT)的相关性。方法选取2017年1月~2020年6月就诊的新生儿高胆红素症患儿共计140例,将NBE患儿作为NBE组(48例),将非NBE患儿设置为非NBE组(92例)。检测两组患儿的血清总胆红素(TBIL)、间接胆红素(IBIL)、NSE及γ-GT水平,分析TBIL,IBIL与NSE,γ-GT的相关性,并探讨二者联合检测对新生儿NBE的诊断价值。结果NBE组患儿血清NSE,γ-GT,TBIL,IBIL水平显著高于非NBE组(P<0.05);血清NSE与γ-GT,TBIL,IBIL呈正相关(P<0.01);γ-GT与TBIL,IBIL呈正相关(P<0.01);TBIL与IBIL呈正相关(P<0.01);血清NSE,γ-GT及二者联合诊断的曲线下面积(AUC)分别为0.873,0.824,0.891,表明二者联合诊断新生儿NBE的准确率最高。NSE,γ-GT及二者联合的约登指数分别为0.651,0.574,0.676,二者联合诊断价值高于单项诊断。结论NBE的诊断与血清NSE,γ-GT呈正相关,二者联合检测价值最大,可作为临床早期评估新生儿NBE的客观依据。

Objective To investigate the correlation of serum neuron-specific enolase(NSE)andγ-glutamyl transpeptidase(γ-GT)in neonatal bilirubin encephalopathy(NBE).Methods A total of 140 infants with neonatal hyperbilirubinemia who visited our hospital from January 2017 to June 2020 were selected.The NBE infants were selected as the NBE group(48 cases),and the non-NBE infants as the non-NBE group(92 cases).The serum levels of total bilirubin(TBIL),indirect bilirubin(IBIL),NSE andγ-GT were detected in the two groups of children,the correlation between TBIL,IBIL and NSE,γ-GT was analyzed,and the diagnostic value of the combined test of the them on neonatal NBE were discussed.Results The serum levels of NSE,γ-GT,TBIL and IBIL in the NBE group were significantly higher than those in the non-NBE group(P<0.05);serum NSE was positively correlated withγ-GT,TBIL and IBIL(P<0.01);γ-GT was positively correlated with TBIL,IBIL(P<0.01);TBIL was positively correlated with IBIL(P<0.01);the areas under the curve(AUC)of serum NSE,γ-GT and their combined diagnosis were 0.873,0.824,and 0.891,respectively,indicating that the two the combined diagnosis of neonatal NBE has the highest accuracy.The Youden indices of NSE,γ-GT and their combination were 0.651,0.574,and 0.676,respectively.The combined diagnostic value of the two was higher than the single diagnosis.Conclusion The diagnosis of NBE is positively correlated with serum NSE andγ-GT,and the combined testing of them has the greatest value,which can be used as an objective basis for early clinical assessment of neonatal NBE.