新生儿高间接胆红素血症血清NSE含量变化及意义  

Changes and significance of serum neuron specific enolase in full-term neonates with unconjugated hyperbilirubinemia

作　　者：陈宝昌[1] 戴兰芬[2] 马亚范[1] 任常军[1] 韩小梅[1] 高静[1] 李彦敏[1] 刘亚平[1] 

机构地区：[1]河北医科大学第一医院儿科,河北石家庄050031 [2]河北省儿童医院,河北石家庄050031

出　　处：《临床儿科杂志》2008年第5期409-412,共4页Journal of Clinical Pediatrics

基　　金：河北省科技攻关课题(No.052761629)

摘　　要：目的探讨高间接胆红素血症(高间胆)新生儿血清神经元特异性烯醇化酶(s-NSE)的变化及其与新生儿行为神经评分(NBNA)的关系及意义。方法应用ELISA法分别测定71例高间胆新生儿和20例正常足月新生儿s-NSE含量,并对所有对象于生后第7天进行NBNA评分;按胆红素数值大小分为轻、中、重3组,按NBNA评分值分为>36分、35～36分、<35分3组。结果高间胆新生儿s-NSE浓度明显高于对照组(P<0.01),重度组高于轻度组(P<0.01),轻度组与中度组、中度组与重度组之间差异均无统计学意义(P>0.05);高间胆组新生儿NBNA评分显著低于对照组(P<0.001);经直线相关分析,s-NSE含量与NBNA评分呈显著负相关(r=0.8843,P<0.001),血清间接胆红素(s-UCB)与NBNA评分相关性较差(r=0.2756,P<0.05),s-UCB与s-NSE无直线相关性。结论s-NSE测定可以反映高胆红素血症新生儿脑损伤;临床以s-NSE含量为依据对新生儿高胆红素血症进行干预更合理。Objectives To investigate the serum level of neuron specific enolase （s-NSE） in full-term neonates with unconjugated hyperbilirubinemia. To explore the correlation between serum unconjugated bilirubin （s-UCB） and s- NSE, neonate behavioral neurological assessment （NBNA） scores. Methods Seventy-one （71） full-term neonates with hyperbilirubinemia were divided into three groups： mild, moderate and severe, according to the level of s-UCB. Twenty （20） healthy full-term neonates with s-UCB levels less than 85.5 μmol/L were recruited as control group, s-NSE levels were determined by enzyme linked immunosorbent assay. NBNA was scored from all subjects on the 7th day after birth. Results Levels of s-NSE in the hyperbilirubinemia groups were significantly higher than that in the control group （ P 〈 0.01 ）. s-NSE level in severe group was obviously higher than that in the mild group （P 〈 0.01 ）. Neither between the mild group and the moderate group, nor between the moderate and the severe group showed any significant differences （P 〉 0.05 ）. By linear correlation analysis, s-NSE levels were inversely associated with NBNA scores （r = 0.8843, P 〈 0.001 ）. The correlation between s-UCB and NBNA scores was poor （r = 0.2756, P 〈 0.05） , and no significant correlation was observed between s-UCB and s-NSE. Conclusions s-NSE level may have potential value of estimating bilirubin-related brain damage, and should, as a biochemical marker, provide an objective basis for reasonable treatment of the neonates with unconjugated hyperbilirubinemia.

关 键 词：新生儿 胆红素 神经元特异性烯醇化酶 

分 类 号：R722.1[医药卫生—儿科]