新生儿缺氧缺血性脑病血清神经元特异性烯醇化酶、髓鞘碱性蛋白的变化及临床意义  

Dynamic changes and clinical significance of neuron-specific enolase and myelin base protein in serum of hypoxic ischemic encephalopathy

作　　者：王筱璐[1] 姚霖[1] 熊远青[1] 姜彦[1] 黄河[1] 余春艳[1] 

机构地区：[1]广东医学院附属福田人民医院儿科,深圳518033

出　　处：《临床医学》2010年第5期44-45,共2页Clinical Medicine

基　　金：深圳市福田区科研基金项目(FTWS044)

摘　　要：目的探讨血清神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)的水平变化在新生儿缺氧缺血性脑病(HIE)中的意义。方法 HIE组足月HIE患儿40例,轻度10例,中度16例,重度14例,对照组为正常足月新生儿10例。分别在1、3 d(急性期),7～10 d(恢复期)采血,用放射免疫法测定NSE,用ELISA法测定MBP,10例健康新生儿作为正常对照组。结果①HIE组在第1天和治疗后第3天,血清NSE水平均高于对照组(P<0.05);在治疗7～10 d后,轻度HIE患儿NSE水平基本恢复正常,而中、重度HIE患儿仍保持较高水平。②重度组HIE患儿急性期MBP水平明显增高(P<0.01)。对照组与轻、中度HIE组血清中MBP水平比较差异无统计学意义(P>0.05),与重度组比较差异有统计学意义(P<0.01)。结论血清NSE水平可作为早期诊断新生儿缺氧缺血性脑病的客观指标,血清MBP检测可作为判断HIE脑损伤程度的参考指标。Objective To investigate the changes of serum neuron specific enolase（NSE） and myelin base protein（MBP） in neonates with hypoxic ischemic encephalopathy（HIE）.Methods Forty newborns with HIE were assigned into three groups,mild HIE group（n=10）,moderate HIE group（n=16） and severe HIE group（n=14）.Ten normal newborns selected as control group.Radio immunoassay measured serm levels of NSE.Serum levels of MBP assayed by ELISA analyzer.Results ① Blood NSE levels in all objective cases were significantly higher than those in the control cases at 1 d after HIE and 3 d after therapy（P〈0.05）.Blood NSE levels in severity degree and moderate degree cases were significantly higher than those in the control cases at 7-10 d after therapy（P〈0.05）,but the NSE levels recovered to normal in slight degree cases.② The serum MBP level in severe group increased obviously during the acute stage（P〈0.01）.There was no significant difference between control group and mild HIE group（P〉0.05）.There was significant difference between the control group and severe group（P〈0.01）.Conclusion The levels of NSE in cord blood are the symbol reflecting the early brain damage.The determination of blood MBP levels can be used to evaluate the degree of brain injury of HIE patient.

关 键 词：缺氧缺血性脑病 新生儿 神经元特异性烯醇化酶 髓鞘碱性蛋白 

分 类 号：R473.72[医药卫生—护理学]