神经元特异性烯醇化酶在婴儿神经系统损伤中的预测价值

Value of neuron-specific enolase in predicting neurological injury in infants

目的探讨血清神经元特异性烯醇化酶(NSE)对婴儿神经系统损伤的预测价值。方法采用回顾性研究方法,选取于2019年11月至2020年11月汕头大学医学院第二附属医院儿科住院治疗并行腰椎穿刺术的发热小婴儿(>28 d~<1岁)为研究对象,共63例,均测定血清NSE水平,患儿以血清NSE水平分为两组,A组血清NSE<33µg/L,共52例[男28例,女24例,月龄2.00(1.00,4.00)月];B组血清NSE≥33µg/L,共11例[男6例,女5例,月龄2.00(1.00,6.75)月]。比较两组患儿的临床表现、脑脊液常规及生化水平、外周血常规水平、凝血指标水平、影像学检查结果。采用t检验、曼-惠特尼U检验、χ^(2)检验。结果A组惊厥发作比例为18/52,而B组为8/11,两组比较差异有统计学意义(χ^(2)=5.441,P=0.020)。A组外周血血小板计数、纤维蛋白原、凝血酶原时间分别为(406.70±121.17)×10^(9)/L、(3.79±0.95)g/L、13.20(12.40,15.10)s,B组外周血血小板计数、纤维蛋白原、凝血酶原时间分别为(304.50±165.28)×10^(9)/L、(2.66±1.08)g/L、15.00(13.33,16.45)s,两组比较差异均有统计学意义(均P<0.05)。A组血钙为2.38(2.23,2.43)mmol/L,B组为2.21(1.95,2.33)mmol/L,两组比较差异有统计学意义(P=0.003)。A组影像学异常患儿12例,B组影像学异常患儿6例,两组比较差异有统计学意义(χ^(2)=4.406,P=0.036)。结论血清NSE水平是婴儿神经系统损伤的重要标志物,可作为早期诊断及判断预后的指标之一。

Objective To investigate the value of serum neuron-specific enolase(NSE)in predicting neurological injury in infants.Methods A total of 63 febrile infants(more than 28 days old but less than 1 year old)who had been hospitalized in Department of Pediatrics,The Second Affiliated Hospital of Shantou University Medical College from November 2019 to November 2020 and had undergone lumbar puncture were selected as the subjects.Serum NSE level was measured in all the subjects.The infants were divided into two groups according to the serum NSE level.In group A,serum NSE<33µg/L was observed in 52 cases,including 28 males and 24 females,aged 2.00(1.00,4.00)months.In group B,serum NSE≥33µg/L was observed in 11 cases,including 6 males and 5 females,aged 2.00(1.00,6.75)months.The clinical manifestations,routine and biochemical examination levels of cerebrospinal fluid,levels of peripheral blood routine examination,coagulation indexes,and imaging results of the two groups were compared.t test,Mann-Whitney U test,andχ^(2) test were used.Results The incidence of convulsive seizures in group A was 18/52,and that in group B was 8/11,with a statistically significant difference between the two groups(χ^(2)=5.441,P=0.020).The platelet count in peripheral blood,fibrinogen,and prothrombin time of group A were(406.70±121.17)×10^(9)/L,(3.79±0.95)g/L,and 13.20(12.40,15.10)s,respectively,and those of group B were(304.50±165.28)×10^(9)/L,(2.66±1.08)g/L,and 15.00(13.33,16.45)s,respectively,with statistically significant differences between the two groups(all P<0.05).The blood calcium level of group A was 2.38(2.23,2.43)mmol/L,and that of group B was 2.21(1.95,2.33)mmol/L,with a statistically significant difference between the two groups(P=0.003).There were 12 cases of abnormal imaging in group A and 6 cases in group B,with a statistically significant difference between the two groups(χ^(2)=4.406,P=0.036).Conclusion Serum NSE level is an important marker of neurological injury in infants,and can be used as one of the indicators for early diagnosis and prognosis evaluation.