血清S-100βNSEMBP动态变化对新生儿颅内出血预后的评估价值  

Value of dynamic changes of serum S-100β,NSE and MBP in evaluating the prognosis of neonatal intracranial hemorrhage

作　　者：云磊[1] 刘军[1] 付杰[1] YUN Lei;LIU Jun;FU Jie(Bozhou People’s Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院,安徽亳州236800

出　　处：《中国实用神经疾病杂志》2023年第11期1360-1364,共5页Chinese Journal of Practical Nervous Diseases

基　　金：国家卫生健康委员医药卫生科技发展研究中心项目(编号:WA2020HK60)。

摘　　要：目的探究血清S-100β蛋白(S-100β)、神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)动态变化对新生儿颅内出血预后的评估价值。方法选取2019-06—2023-06亳州市人民医院收治的85例ICH新生儿为观察组,并选取同期在本院分娩的健康新生儿70例作为对照组,根据观察组预后情况分为痊愈组(n=55)和未愈组(n=30),比较各组血清S-100β、NSE、MBP水平,采用ROC曲线分析血清S-100β、NSE、MBP水平对新生儿颅内出血患儿预后不良的预测价值。结果观察组患儿出生后24 h、72 h、7 d的血清S-100β、NSE、MBP水平高于对照组(P<0.05),观察组患儿出生后72 h的血清S-100β、NSE、MBP水平最高,出生后7 d下降(P<0.05)。ICH IV级患儿出生后24 h、72 h、7 d的血清S-100β、NSE、MBP水平高于ICHⅢ级、Ⅱ级和Ⅰ级患儿,ICHⅢ级患儿出生后24 h、72 h、7 d的血清S-100β、NSE、MBP水平高于ICHⅡ级和Ⅰ级患儿,ICHⅡ级患儿出生后24 h、72 h、7 d的血清S-100β、NSE、MBP水平高于ICHⅠ级患儿(P<0.05)。未愈组患儿出生后24 h、72 h、7 d的血清S-100β、NSE、MBP水平高于痊愈组(P<0.05)。ROC曲线分析显示,出生后72 h的血清S-100β、NSE、MBP水平联合预测新生儿颅内出血患儿预后不良的敏感度为93.35%,AUC为0.922,均高于单独检测(P<0.05)。结论ICH患儿血清S-100β、NSE、MBP水平随发病时间发生显著变化,与ICH分级、预后密切相关,且联合检测对ICH患儿预后不良的预测价值较高。Objective To investigate the clinical value of dynamic changes of serum S-100βprotein(S-100β),neuron specific enolase(NSE)and myelin basic protein(MBP)in the prognosis of neonates with intracranial hemorrhage(ICH).Methods Totally 85 neonates with ICH admitted to the Bozhou People’s Hospital from June 2019 to June 2023 were selected as the observation group,and 70 healthy neonates who were born in the hospital during the same period were selected as the control group.According to the prognosis,neonates in the observation group were divided into the cured group(n=55)and the not cured group(n=30).Serum S-100β,NSE and MBP levels in different groups were compared.The value of serum S-100β,NSE and MBP levels in predicting poor prognosis of neonates with ICH was analyzed using the ROC curve.Results Serum S-100β,NSE and MBP levels in the observation group at 24 h,72 h and 7 d after birth were higher than those in the control group(P<0.05).Serum S-100β,NSE and MBP levels in the observation group were the highest at 72 h after birth,and decreased 7 d after birth(P<0.05).The levels of S-100β,NSE and MBP in serum of ICH gradeⅣchildren 24 h,72 h and 7 d after birth were higher than those of ICH gradeⅢ,Ⅱand I children,and the levels of S-100β,NSE and MBP in serum of ICH gradeⅢchildren 24 h,72 h and 7 d after birth were higher than those of ICH gradeⅡand I children.The levels of S-100β,NSE and MBP in children with ICH gradeⅡat 24 h,72 h and 7 d after birth were higher than those in children with ICH grade I(P<0.05).The levels of S-100β,NSE and MBP in the untreated group were higher than those in the cured group at 24 h,72 h and 7 d after birth(P<0.05).ROC curve analysis showed that the sensitivity and AUC of the combination of serum S-100β,NSE and MBP levels at 72 h after birth to predict poor prognosis of neonates with ICH were 93.35%and 0.922,both of which were higher than those of single prediction(P<0.05).Conclusion Serum S-100β,NSE and MBP levels in neonates with ICH change significantly with the

关 键 词：颅内出血 S-100Β蛋白 神经元特异性烯醇化酶 髓鞘碱性蛋白 预后 

分 类 号：R722.151[医药卫生—儿科]