神经元特异性烯醇酶在早期评估新生儿缺氧缺血性脑病预后中的价值  

Role of neuron specifie enolase for early assesment of prognosis of neontal hypexic-ischemic encephalopathy

作　　者：黄燕萍[1] 李小权[1] 王安生[2] 康燕[1] 罗树舫[1] 史瑞明[1] 辛华[1] 李改莲[1] 邓素莲[1] 

机构地区：[1]西安交通大学第一医院儿科,710061 [2]西安市中心医院神经科

出　　处：《新生儿科杂志》2005年第1期23-26,共4页The Journal of Neonatology

摘　　要：目的探讨神经元特异性烯醇酶(NSE)、新生儿行为神经测定(NBNA)缺氧缺血性脑病(HIE)临床分度和CT分度等方法在HIE预后判断早期评估中的意义。方法 对30例HIE患儿在生后第2天检测血清NSE浓度,生后7 d内进行临床分度、CT分度和NBNA评分,10例足月新生儿为对照组。结果HIE组血清NSE浓度明显高于对照组。重度HIE组的NSE高于轻、中度HIE组。HIE组的NBNA评分低于对照组(P<0.01),重度HIE组的NBNA低于轻、中度HIE患儿。头部CT呈轻、中、重度改变的HIE患儿NSE浓度高于对照组;NBNA评分低于对照组,其中重度CT改变的HIE患儿NSE高于轻、中度组,NBNA则低于轻、中度组。血清NSE浓度分别与HIE临床分度、CT分度呈正相关,与NBNA评分呈负相关;HIE临床分度、CT分度、NBNA及血清NSE浓度预测预后的敏感性分别为100％、100％、85.71％、和100％,特异性分别为45.45％、45.45％、51.66％和58.33％。结论血清NSE浓度对HIE预后的预测价值较高,为HIE预后的早期评估提供了新的参考指标。Objective To study the effects of different methods to predict early prognosis of neonatal hypoxic ischemic .encephalopathy (HIE) . Methods The levels of serum neuron specific enolase(NSE) was detected in 30 neonates with HIE on the second day of life. The brain CT and Neonatal behavioral neurological assessment (NBNA) were performed within 7 days after birth to assess the degree of brain injury.Development of intelligence was tested during 6 months ~1 year old. Ten healthy neonates served as controls.Results The serum NSE level of HIE neonates (43.94±24.09)μg/L was significantly higher than that of the normal control(8.33±2.78)μg/L. The NSE level of severe HIE neonate was higher than that of the mild and moderate HIE neonates (P<0.01).NBNA score in HIE group was lower than that in normal control (P<0.01) and NBNA score of severe HIE neonate was lower than thatof mild and moderate HIE neonates (P<0.01).Higher NSE levels and Lowoer NBNA score were noted in HIE infants with brain CT HIE signs. (P<0.01, and 0.05) . The levels of serum NSE was related positively with HIE clinical degree and CT degree, but related negatively with NBNA.The sensitivity to predict prognosis by clinical degree,CT degree,NBNA and serum NSE levels was 100%, 100%, 85.71%, and 100%, respectively.The specificity of them was 45.45%, 45.45%, 51.66% and 58.33%, respectively.Conclusions Clinical degree is a basic marker to predict prognosis of HIE, the level of serum NSE has a more important value in evaluating the prognosis of HIE.

关 键 词：HIE NBNA NSE 对照组 临床分度 早期评估 CT分度 结论 评分 负相关 

分 类 号：R722.1[医药卫生—儿科]