高胆红素血症新生儿血清神经元特异性烯醇化酶水平变化及意义  

Changes and singnificance of serum neuro-specific enolase in neonates with hyperbilirubinemia.

作　　者：袁传顺[1] 陈吉庆[2] 陆超[2] 徐莉[1] 陈新跃[1] 杜娟[1] 张子前 周亚红[1] 

机构地区：[1]江苏省常州市第七人民医院儿科,江苏常州213011 [2]南京医科大学第一附属医院儿科,江苏南京210029

出　　处：《海南医学》2009年第7期4-7,共4页Hainan Medical Journal

基　　金：2007年常州市卫生局指导性科技项目(WZ200743);江苏省卫生厅医学科技发展基金(K200504)

摘　　要：目的探讨血清神经元特异性烯醇化酶(s-NSE)水平与新生儿行为神经测定(NBNA)的相关性,探讨s-NSE在急性胆红素脑病(ABE)发生、发展中的价值。方法对63例高胆红素血症新生儿在高胆期及黄疸消退后分别采用电化学发光免疫法测定s-NSE及行NBNA,生后1、3、6个月追踪随访,并与24例正常新生儿对照。结果高胆期:s-NSE水平随血清总胆红素(TSB)升高而升高,各组s-NSE水平比较差异有统计学意义(F=56.287,P<0.01);高胆组NBNA评分明显下降,NBNA评分随TSB升高而降低,各组NBNA评分比较差异有统计学意义(F=50.247,P<0.01);s-NSE水平与NBNA评分间呈显著负相关(r=-0.609,P<0.01)。高胆消退后,s-NSE水平均有明显下降,NBNA评分同步上升。结论高胆红素血症患儿s-NSE浓度显著升高,与NBNA评分呈负相关,可以作为临床早期监测新生儿是否进入ABE的危险期的一个生物学指标。Objective To investigate the level of serum neuro -specific enolase （s -NSE） and the correlation between s- NSE and neonatal behavioral neurological assessment（NBNA） scores in full -term neonates with hyperbilirubinemia. Methods The level of s - NSE was measured by in 63 full - term neonates with hyperbilirubinemia and 24 physio - bilirubinemia neonates as control at the stage of hyperbilirubinemia and post - hyperbilirubinemia. In the same time, NBNA was scored from all subjects and following - up visit in the 1st, 3rd, 6th month after birth. Results At the stage of hyperbilirubinemia： the level of s - NSE was increased significantly with the increase of serum total biliruhin（TSB） , and there were signifiant differences among the mild group, the moderate group, the severe group and the control group （ F =56.287, P 〈0.01）, while NBNA score was declined significantly with the increase of TSB, and there were signifiant differences among the mild group, the moderate group, the severe group and the control group （ F = 50.247, P 〈 0. 01 ）. By linear correlation analysis, s - NSE level was inversely associated with NBNA score （ r = - 0.609, P 〈 0.01 ）. Following the levels of TSB extincted, the level of s - NSE was declined significantly, while NBNA scores were increased significantly. Conclusion The level of s - NSE increases significantly in neonates complicated with hyperbilirubinemia and the level is inversely associated with NBNA score, and hence s - NSE level may be used as a sensitive biological marker for the early estimating of acute bilirubin encephalopathy.

关 键 词：高胆红素血症 新生儿 急性胆红素脑病 神经元特异性烯醇化酶 新生儿行为神经测定 

分 类 号：R722.1[医药卫生—儿科]