新生儿缺氧缺血性脑病血清NSE和VILIP-1水平变化及意义
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摘要
目的探讨新生儿缺氧缺血性脑病(HIE)血清神经元特异性烯醇化酶(NSE)和视椎蛋白样蛋白1(VILIP-1)水平变化及意义。方法选取2012年3月至2015年4月在郑州市儿童医院住院治疗的136例HIE患儿,根据病情分为轻度(n=58)、中度(n=46)、重度(n=32),同期,选取正常新生儿45例作为对照组,HIE患儿分别于出生后第24小时(T0)、48小时(T_1)、72小时(T_2)和7天(T_3)时,对照组于T_0时,检测血清中NSE和VILIP-1水平,HIE患儿和对照组均于T_0时,进行新生儿行为神经测定(NBNA)评分。结果 HIE患儿T_0时血清NSE和VILIP-1水平分别为(28.82±6.34)、(0.91±0.26)μg/L,均高于对照组的(13.94±2.82)、(0.38±0.15)μg/L,NBNA评分为(33.83±2.25)分,低于对照组的(38.24±2.41)分,差异均有统计学意义(P<0.05);Pearson相关分析显示,HIE患儿T_0时血清NSE水平与VILIP-1水平呈正相关(r=0.612,P<0.05),血清NSE和VILIP-1水平均与NBNA评分呈负相关(r=-0.481、-0.440,P<0.05);与轻度相比,中度和重度患儿T_(0~3)时血清NSE和VILIP-1水平均升高,且重度均高于中度,差异均有统计学意义(P<0.05)。结论 HIE患儿血清NSE和VILIP-1水平升高,动态监测血清NSE和VILIP-1水平对HIE早期诊断、病情判定及治疗效果评估具有重要意义。
Objective To investigate the changes and significance of serum NSE and VILIP-1 in hypoxic-ischemic encephalopathy. Methods A total of 136 cases of children with HIE were selected from March 2012 to April 2015 in Zhengzhou City Children's Hospital and were divided into mild( n = 58),moderate( n = 46) and severe( n = 32),according to the condition of patients. At the same time,45 cases of normal newborns were selected as the control group. The serum levels of NSE and VILIP-1 in HIE children after born( T_0),48 h( T_1),72 h( T_2) and 7 d( T_3),and in control group,at T_0,were respectivelydetected. The NBNA scores were evaluated at birth 24 h in HIE children and control group. Results The serum levels of NSE and VILIP-1 in HIE children at T_0 were( 28. 82 ± 6. 34) μg/L,( 0. 91 ± 0. 26) μg/L,respectively,which were higher than the control group [( 13. 94 ± 2. 82) μg/L,( 0. 38 ± 0. 15) μg/L],while the NBNA score [( 33. 83 ± 2. 25) point] was lower than that of the control group [( 38. 24 ± 2. 41) point],andthe differences were statistically significant( P < 0. 05). Pearson correlation analysis showed,at T_0,the serum level of NSE in HIE children was positively correlated with the level of VILIP-1( r = 0. 612,P < 0. 05),while the serum levels of NSE and VILIP-1 were negatively correlated with NBNA scores( r =-0. 481 and-0. 440,P < 0. 05). Compared with mild,the serum levels of NSEand VILIP-1 at T_(0 ~ 3) in moderate and severe increased,and were higher in severethan in the moderate,and the differences were statistically significant( P < 0. 05). Conclusion The serum levels of NSE and VILIP-1 in HIE children are elevated. It is of great significance for dynamic monitoring of serum levels of NSE and VILIP-1 in early diagnosis,condition determination and treatment assessmentof HIE.
Objective To investigate the changes and significance of serum NSE and VILIP-1 in hypoxic-ischemic encephalopathy. Methods A total of 136 cases of children with HIE were selected from March 2012 to April 2015 in Zhengzhou City Children's Hospital and were divided into mild( n = 58),moderate( n = 46) and severe( n = 32),according to the condition of patients. At the same time,45 cases of normal newborns were selected as the control group. The serum levels of NSE and VILIP-1 in HIE children after born( T_0),48 h( T_1),72 h( T_2) and 7 d( T_3),and in control group,at T_0,were respectivelydetected. The NBNA scores were evaluated at birth 24 h in HIE children and control group. Results The serum levels of NSE and VILIP-1 in HIE children at T_0 were( 28. 82 ± 6. 34) μg/L,( 0. 91 ± 0. 26) μg/L,respectively,which were higher than the control group [( 13. 94 ± 2. 82) μg/L,( 0. 38 ± 0. 15) μg/L],while the NBNA score [( 33. 83 ± 2. 25) point] was lower than that of the control group [( 38. 24 ± 2. 41) point],andthe differences were statistically significant( P < 0. 05). Pearson correlation analysis showed,at T_0,the serum level of NSE in HIE children was positively correlated with the level of VILIP-1( r = 0. 612,P < 0. 05),while the serum levels of NSE and VILIP-1 were negatively correlated with NBNA scores( r =-0. 481 and-0. 440,P < 0. 05). Compared with mild,the serum levels of NSEand VILIP-1 at T_(0 ~ 3) in moderate and severe increased,and were higher in severethan in the moderate,and the differences were statistically significant( P < 0. 05). Conclusion The serum levels of NSE and VILIP-1 in HIE children are elevated. It is of great significance for dynamic monitoring of serum levels of NSE and VILIP-1 in early diagnosis,condition determination and treatment assessmentof HIE.
引文
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[12]WANG H,ZHANG L,JIN Y.A meta-analysis of the protective effect of recombinant human erythropoietin(rh EPO)for neurodevelopment in preterm infants[J].Cell Biochem Biophys,2015,71(2):795-802.
[2]顾学范.儿童遗传代谢病的诊断和预防[J].诊断学理论与实践,2014,13(1):7-11.
[3]AWAL M A,LAI M M,AZEMI G,et al.EEG background features that predict outcome in term neonates with hypoxic ischaemic encephalopathy:a structured review[J].Clin Neurophysiol,2016,127(1):285-296.
[4]CULLER L,WHITCOMB J,WEBSTER S.Serum neuron-specific enolase predicting neurological outcomes post-cardiac arrest:a review of the literature[J].Dimens Crit Care Nurs,2014,33(6):309-315.
[5]SHAHIM P,MATTSSON N,MACY E M,et al.Serum visinin-like protein-1 in concussed professional ice hockey players[J].Brain Inj,2015,29(7-8):872-876.
[6]中华医学会儿科学分会新生儿学组.新生儿缺氧缺血性脑病诊断标准[J].中国当代儿科杂志,2005,7(2):97-98.
[7]陈爽花,戴玉璇.神经节苷脂联合丹参注射液在新生儿缺氧缺血性脑病治疗中的应用价值[J].中华全科医学,2016,14(2):254-255,260.
[8]李艳,杜奕,陈志强,等.缺氧缺血性脑病患儿表观扩散系数与行为神经测定评分的相关性研究[J].中华放射学杂志,2015,49(2):133-137.
[9]GAO J,ZHENG Z.Development of prognostic models for patients with traumatic brain injury:a systematic review[J].Int J Clin Exp Med,2015,8(11):19881-19885.
[10]MIR I N,CHALAK L F.Serum biomarkers to evaluate the integrity of the neurovascular unit[J].Early Hum Dev,2014,90(10):707-711.
[11]刘晓丽,张秀芝,孙长义,等.VILIP-1和NR2多肽联合检测在早期缺血性脑卒中的临床诊断价值[J].中华检验医学杂志,2014,37(6):469-472.
[12]WANG H,ZHANG L,JIN Y.A meta-analysis of the protective effect of recombinant human erythropoietin(rh EPO)for neurodevelopment in preterm infants[J].Cell Biochem Biophys,2015,71(2):795-802.