0~6个月龄脑瘫高危儿血清NSE、IL-6水平及临床价值  

Levels of serum NSE and IL-6 in high-risk cerebral palsy of 0-6 months old infants and their clinical value

作　　者：范忠媛 鄢毅[1] 张光梅 FAN Zhong-yuan;YAN Yi;ZHANG Guang-mei(Department of Pediatrics,Neijiang First People′s Hospital,Neijiang 641000,China)

机构地区：[1]内江市第一人民医院儿科,四川内江641000

出　　处：《热带医学杂志》2020年第12期1565-1568,共4页Journal of Tropical Medicine

基　　金：四川省卫生和计划生育委员会(川卫办发[2015]151号)。

摘　　要：目的探讨血清神经元特异性烯醇化酶(NSE)与白介素-6(IL-6)在0~6个月龄脑瘫高危儿体内水平以及其临床价值。方法将内江市第一人民医院儿科2015年6月-2018年6月期间收治150例0~6个月龄脑瘫高危患儿作为高危脑瘫组,同期在儿科进行体检160名0~6个月健康婴儿作为对照组。比较两组婴儿血清学指标NSE、IL-6水平,发育商评分、粗大运动功能测试量表(CMFM-88)评分,分析血清学指标与发育商评分、CMFM-88评分的相关性,采用血清学指标判断脑瘫高危患儿预后情况。结果高危脑瘫组婴儿血清NSE水平显著高于对照组[(36.22±5.19)μg/L vs.(12.87±3.06)μg/L],差异有统计学意义(P<0.05),而两组IL-6水平差异无统计学意义(P>0.05)。高危脑瘫组婴儿发育商评分、CMFM-88评分均显著低于对照组,差异有统计学意义(t=24.471、10.254,P均<0.05)。血清NSE与发育商评分、CMFM-88评分均呈负相关(r=-0.351、-0.418,P均<0.05),血清IL-6与发育商评分、CMFM-88评分均不相关(r=-0.129、-0.096,P均>0.05)。ROC曲线显示,血清NSE、IL-6最佳截断值分别为36.35μg/L、34.32 pg/mL时,高危脑瘫患儿随访期间预后不良AUC分别为0.815和0.739,两者预测高危脑瘫患儿预后不良灵敏度分别为84.34%和66.26%,特异度分别为79.34%和70.85%。结论 0~6个月龄脑瘫高危患儿血清NSE水平异常上升,可以用于评估患儿智力运动情况以及预测患儿预后。Objective To explore levels of serum neuron specific enolase(NSE) and interleukin-6(IL-6) in high-risk cerebral palsy of 0-6 months old infants and their clinical value.Methods The 150 high-risk cerebral palsy of 0-6 months old infants who were admitted to pediatric department of Neijiang First People ’s Hospital from June 2015 to June 2018 and 160 healthy 0-6 months old infants who underwent physical examination in pediatric department during the same period were enrolled as high-risk cerebral palsy group and control group,respectively.The levels of serology indexes NSE and IL-6,scores of development quotient and intelligence quotient and gross motor function measure(GMFM-88),correlation between serology indexes and scores of development quotient and GMFM-88,and prognosis determined by serology indexes were compared between the two groups.Results The level of serum NSE in high-risk cerebral palsy group was significantly higher than that in control group(P<0.05).There was no significant difference in IL-6 level between control group and high-risk cerebral palsy group(P>0.05).The scores of development quotient and GMFM-88 in high-risk cerebral palsy group were significantly lower than those in control group(t=24.471,10.254,P<0.05).Serum NSE was negatively correlated with scores of development quotient and GMFM-88(r=-0.351,-0.418,P<0.05),while serum IL-6 was not correlated with them(r=-0.129,-0.096,P>0.05).ROC curve showed that when optimal cutoff values of serum NSE and IL-6 were 36.35 μg/L and 34.32 pg/mL,AUC of high-risk cerebral palsy infants with poor prognosis during follow-up were 0.815 and 0.739,respectively.The sensitivity and specificity of the two for predicting poor prognosis of high-risk cerebral palsy infants were(84.34%,66.26%) and(79.34%,70.85%),respectively.Conclusion The level of serum NSE was abnormally increased in high-risk cerebral palsy infants aged 0-6 months old,which could be applied to assess their intellectual movement and predict prognosis.

关 键 词：脑瘫高危儿 神经元特异性烯醇化酶 白介素-6 

分 类 号：R742.3[医药卫生—神经病学与精神病学]