儿童血清和脑脊液中NSE正常参考值的测定及其临床应用价值

The determination of normal value and clinical significance for NSE in serum and CSF in children

目的确定正常健康儿童不同年龄之间血清和脑脊液中神经元特异性烯醇化酶( )正常参考值,了解血清和脑脊液中 NSENSE 之间的变化规律,探讨影响实验结果的各种因素以及血清和脑脊中 NSE 在新生儿 H IE 时的变化及其规律。方法:应用酶联免疫法测定正常健康儿童和患有 H IE 的新生儿血清和脑脊液中 NSE 水平。结果: 例正常健康儿童血清及脑脊液中 NSE 的水平,在 66性别、年龄之间均无显著性差异( t=0.148、 , 均> 0.05);影响血清和脑脊液中 NSE 检测结果的因素包括标本的采集方法、保存 1.73 P及冻融、标本量及操作等; H IE 患儿血清及脑脊液中 NSE 与病情轻重密切相关,即 H IE 越重, NSE 升高越明显,轻、中、重三种类型H IE 三者分别相比,差异非常显著( t=2.95￣6.38, < 0.01);健康儿童和 H IE 患儿血清 NSE 水平的变化与脑脊液中 NSE 水平的变化 P成正相关( r=83.5￣87.3)。结论:儿童由于血清和脑脊液中 NSE 水平没有性别及年龄差异,故只需设置一个正常参考值;检测血清中NSE 的改变情况可以反映大脑神经元受损的情况;检测血清和脑脊液中 NSE 水平变化可以帮助判断 H IE 患儿病情的轻重,

Objective: To define the reference range for Neuron-specific enolase (NSE) in serum and cerebrospinal fluid (CSF) among different ages, and explore the relatoinship of NSE levels between in serum and in CSF among both healthy children and neonates with HIE, meanwhile, to discuss various kinds of factors having influence on the result of the test. Methods: The NSE levels in serum and CSF were measured by ELISA in healthy children and neonates with HIE. Results: The NSE levels in serum and CSF didn't correlated with sex and age in 66 healthy children. The specimen collection, preservation, dose of specimen and the process of operation were found as the factors influencing the test determination. The NSE levels in serum and CSF in neonates with HIE correlated greatedly with the severity of the patient's condition (t=2.95~6.38, P < 0.01). The changes of NSE levels in serum of both heathy children and neonates with HIE were very correlated to those in CSF (r=83.5~87.3). Conclusion: Since the NSE levels in children's serum and CSF have no diffences in sex and age, only one normal value is needed for all children. The change of NSE level in serum can reflect the degree of neuron injury. The determination of NSE in serum and CSF can be used to estimate the severity of HIE in children, and to direct the treatment of these patients.