神经元特异性烯醇化酶在宫内窘迫新生儿脑损伤早期的变化研究

Research on Change of Neuron-Specific Enolase in Early Stage of Brain Injury in Newborns with Intrauterine Distress

目的:研究神经元特异性烯醇化酶(NSE)在宫内窘迫新生儿脑损伤早期的变化。方法:选取2015年1月—2018年7月广州市南方医科大学南方医院收治的62例宫内窘迫新生儿作为研究对象,依据出生第1天NSE水平是否>30.0μg/L分为低水平组与高水平组,各31例。两组均接受头颅MRI、NSE检查,比较不同时间点情况。结果:低水平组出生后1、4、7 d NSE水平低于高水平组,差异有统计学意义(P<0.05)。低水平组出生后7、14 d新生儿神经行为测定评分高于高水平组,差异有统计学意义(P<0.05)。低水平组头颅MRI检查异常信号阳性率低于高水平组,差异有统计学意义(P=0.019)。结论:早期NSE水平较高时,多数宫内窘迫新生儿脑损伤情况较为严重,提示NSE水平可为宫内窘迫新生儿脑损伤的早期诊断提供参考依据。

Objective:To investigate the change of neuron-specific enolase(NSE)in early stage of brain injury in newborns with intrauterine distress.Sixty-two cases of intrauterine distress neonates admitted to the neonatology Center of Nanfang Hospital,Southern Medical University,Guangzhou from January 2015 to July 2018 were studied.According to whether the NSE level on the first day after birth was>30.0μg/L,these newborns were divided into low level group and high level group,with 31 cases in each group.Both groups were examined by head MRI and for NSE level.The change at different time points was compared.Results:The levels of NSE in the low level group were lower than those in the high level group on 1 d,4 d and 7 d after birth,and the difference was statistically significant(P<0.05).The Neonatal Behavioral Neurological Assessment scores in the low level group were higher than those in the high level group on 7 d and 14 d after birth,and the difference was statistically significant(P<0.05).The positive rate of abnormal signal in head MRI in the low level group was lower than that in the high level group,and the difference was statistically significant(P=0.019).Conclusion:When the NSE level is high in early stage,brain injury in most newborns with intrauterine distress is severe,suggesting that the NSE level can provide a reference for the early diagnosis of brain injury in newborns with intrauterine distress.