缺氧缺血性脑病新生儿头颅CT与血清NSE及外周血细胞Smac mRNA的关系  

Relationship of CT scans with serum neuron specific enolase and Smac mRNA in newborn infants with hypoxia-ischemia brain damage

作　　者：袁传顺 周艳[2] 瞿云 陆超[2] 

机构地区：[1]常州市戚墅堰区人民医院儿科,213011 [2]南京医科大学第一附属医院儿科

出　　处：《江苏医药》2007年第12期1196-1198,共3页Jiangsu Medical Journal

基　　金：江苏省卫生厅医学科技发展基金(K200504)

摘　　要：目的探讨缺氧缺血性脑损伤新生儿血清神经元特异性烯醇化酶(NSE)和外周血单核细胞第二线粒体源的半胱天冬酶激活物(Smac)的mRNA的变化。方法65例新生儿在出生后24h采集血标本,2h内分离血清,用电发光化学法检测NSE浓度。沉淀的血细胞用Trizol一步法提取RNA,通过逆转录聚合酶链反应(RT-PCR)检测分析其中Smac mRNA的水平。1周左右行头颅CT检查。结果影像学检查阳性组(26例)和阴性组(39例)血清NSE浓度分别为(32.73±10.20)μg/L和(14.23±7.14)μg/L,(P<0.01),以β-肌动蛋白为内参照的Smac mRNA相对水平分别为(0.43±0.12)和(0.19±0.08),(P<0.01)。血清NSE浓度与5-minApgar评分呈负相关(r=-0.849,P<0.01),与Smac mRNA相对量呈高度正相关(r=0.975,P<0.01)。结论外周血血清NSE和Smac mRNA水平可作为临床早期评价新生儿脑损伤严重程度的客观指标。Objective To study the changes of neuron specific enolase（NSE） in serum and the levels of Smac mRNA in mononuclear blood cells and their relationship with CT scans. Methods The serum NSE concentrations were detected by electroluminescence immunochemistry in 65 newborn within 24 hours after birth. The levels of Smac mRNA were measured by reverse transcriptase polymerase chain reaction （RT-PCR） after RNA extracted with Trizol one-step kit. A cranial CT scaning was performed in about a week. Results The serum NSE concentrations in positive CT group were higher than those in the negative CT groupm（32. 73±10. 20） vs. （14. 23±7.14） μg/L] （P〈 0. 01）. The relative levels of Smac mRNA compared with actin in positive CT group and negative CT group were（0. 43±0. 12） and （0. 19±0. 08）, respectively（P〈0. 01）. The serum NSE concentrations were significantly negatively correlated with 5-min Apgar scores （ r =-0. 849, P〈 0.01）, and the relative levels of Smac mRNA were significantly positively correlated with 5-min Apgar scores （r = 0. 975 ,P〈0. 01）. Conclusion The serum NSE concentrations and the relative levels of Smac mRNA can be used as the early objective markers for evaluating the prognosis of brain damage in newborn.

关 键 词：新生儿 缺氧缺血性脑损伤 神经元特异性烯醇化酶 第二线粒体源的半胱天冬酶激活物 

分 类 号：R722[医药卫生—儿科]