血清NSE在金双歧、茵栀黄及蓝光照射治疗高胆红素血症新生儿脑损伤前后的临床意义
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摘要
目的分析血清神经元特异性烯醇化酶(NSE)含量在金双歧、茵栀黄及蓝光照射治疗前后高胆红素血症新生儿脑损伤的关系。方法对130例高胆红素血症新生儿在治疗前及治疗后分别采用酶联免疫法测定血清NSE,同时行新生儿神经行为测定(NBNA)评分及急性胆红素脑病(ABE)的胆红素致神经功能障碍(BIND)评分,按血清总胆红素(TBIL)严重程度分为试验组和对照组,试验组包括:轻度升高组(A组):205.2μmol/L342.0μmol/L。对照组:金双歧、茵栀黄及蓝光照射治疗后的患儿TBIL<91.9～171.0μmol/L。比较各组高胆红素血症新生儿治疗前后血清NSE、NBNA评分及BIND评分,并对血清NSE与NBNA评分及BIND评分进行相关性分析。结果各组高胆红素血症新生儿血清NSE、NBNA评分及BIND评分治疗前后差异均具有统计学意义(Ps<0.05)。血清NSE与NBNA评分呈负相关(r=-0.869,P<0.01);血清NSE与BIND评分呈正相关(r=0.577,P<0.01)。结论血清NSE水平变化可作为高胆红素血症新生儿脑损伤的检测指标。
Objective To explore the association between hyperbilirubinemia-induced neurological dysfunction and levels of neuron-specific enolase(NSE)in newborns. Methods Full-term(n=130)newborns with hyperbilirubinemia were divided into four groups based on their blood bilirubin concentration.Serum levels of NSE were assessed using enzyme-linked immunosorbent assay(ELISA)before and after golden bifid and phototherapy treatment.Total serum bilirubin(TBIL)levels were measured according to previously published protocols and used to divide the full-term newborns into three groups,i.e. Group A with mild elevation(205.2 μmol/L342.0 μmol/L).The control group consisted of newborns who had received phototherapy and exhibited TSB levels in the range of 91.9-171.0 μmol/L.Neurological dysfunction was determined before and after phototherapy by neonatal behavioral neurological assessment(NBNA)and bilirubin-induced neurologic dysfunction(BIND)scores.And the correlation between serum NSE and scores of NBNA and BIND was analyzed. Results The levels of serum NSE and total serum bilirubin(TSB)elevated in full-term neonates with hyperbilirubinemia before phototherapy,but decreased significantly after treatment(P<0.05).NBNA and BIND scores also improved significantly following treatment(P<0.05).Serum level of NSE was negatively correlated with NBNA score,while positively correlated with BIND score. Conclusion Serum NSE levels are associated with clinical manifestations of bilirubin-induced neurotoxicity,and can be used as a reference index in clinical monitoring of neonatal hyperbilirubinemia-induced brain injury.
Objective To explore the association between hyperbilirubinemia-induced neurological dysfunction and levels of neuron-specific enolase(NSE)in newborns. Methods Full-term(n=130)newborns with hyperbilirubinemia were divided into four groups based on their blood bilirubin concentration.Serum levels of NSE were assessed using enzyme-linked immunosorbent assay(ELISA)before and after golden bifid and phototherapy treatment.Total serum bilirubin(TBIL)levels were measured according to previously published protocols and used to divide the full-term newborns into three groups,i.e. Group A with mild elevation(205.2 μmol/L
引文
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[8] SHEN Xiangmei. Jinshuangqi and Yinzhihuang oral liquid combined with blue light in treatment of neonatal jaundice[J]. Chin J Microecol, 2015, 27(2): 203-204. (in Chinese) 沈向梅. 金双歧、茵栀黄及蓝光照射治疗前后新生儿高胆红素血症临床研究[J]. 中国微生态学杂志, 2015, 27(2): 203-204.
[9] LIU Yan, SUN Nan, WANG Yumei, et al. Accuracy analysis of 5 neuronal enolase detection kits[J]. J Pharmac Analysis, 2014, 34(4): 733-736. (in Chinese) 刘艳, 孙楠, 王玉梅, 等. 5种神经元烯醇化酶检测试剂盒准确性分析[J]. 药物分析杂志, 2014, 34(4): 733-736.
[10] PENG Hao, PU Youhua. Dynamic changes in serum neuron-specific enolase levels in neonates[J]. Chin J Contemp Pediatr, 2014, 16(11): 1122-1124. (in Chinese) 彭好, 蒲友华. 新生儿生后血清神经元特异性烯醇化酶浓度的动态变化[J]. 中国当代儿科杂志, 2014, 16(11): 1122-1124.
[2] Chaves ML, Camozzato AL, Ferreira ED, et al. Serum levels of S100B and NSE proteins in Alzheimer′s disease patients[J]. J Neuroinflammation, 2010, 7: 6.
[3] 沈晓明, 王卫平. 儿科学[M]. 北京: 人民卫生出版社, 2008, 114-122.
[4] 鲍秀兰. 新生儿行为能力和检查方法[J]. 实用诊断与治疗杂志, 2003, 17(6): 441-443.
[5] Johnson L, Bhutani VK, Karp K, et al. Clinical report from the pilot USA Kernicterus Registry(1992 to 2004)[J]. J Perinatol, 2009, 29(Suppl 1): S25-S45.
[6] 《中华儿科杂志》编辑委员会, 中华医学会儿科学分会新生儿学组. 新生儿黄疸诊疗原则的专家共识[J]. 中华儿科杂志, 2010, 48(9): 685-686.
[7] 周丽. 金双歧辅治早产儿高胆红素血症76例[J]. 实用儿科临床杂志, 2007, 22(14): 1102-1103.
[8] SHEN Xiangmei. Jinshuangqi and Yinzhihuang oral liquid combined with blue light in treatment of neonatal jaundice[J]. Chin J Microecol, 2015, 27(2): 203-204. (in Chinese) 沈向梅. 金双歧、茵栀黄及蓝光照射治疗前后新生儿高胆红素血症临床研究[J]. 中国微生态学杂志, 2015, 27(2): 203-204.
[9] LIU Yan, SUN Nan, WANG Yumei, et al. Accuracy analysis of 5 neuronal enolase detection kits[J]. J Pharmac Analysis, 2014, 34(4): 733-736. (in Chinese) 刘艳, 孙楠, 王玉梅, 等. 5种神经元烯醇化酶检测试剂盒准确性分析[J]. 药物分析杂志, 2014, 34(4): 733-736.
[10] PENG Hao, PU Youhua. Dynamic changes in serum neuron-specific enolase levels in neonates[J]. Chin J Contemp Pediatr, 2014, 16(11): 1122-1124. (in Chinese) 彭好, 蒲友华. 新生儿生后血清神经元特异性烯醇化酶浓度的动态变化[J]. 中国当代儿科杂志, 2014, 16(11): 1122-1124.