头颅MRI联合血清S-100蛋白、NSE对高胆红素血症新生儿脑损伤诊断价值  

Diagnostic Value of Cranial MRI Combined with Serum S-100 Protein and NSE on Brain Injury in Neonates with Hyperbilirubinemia

作　　者：王卫国 谢蒙萌 张兰芳 杨晓宇 郭振 WANG Wei-guo;XIE Meng-meng;ZHANG Lan-fang;YANG Xiao-yu;Guo Zhen(Department of Neonatology,Kaifeng Children's Hospital,Kaifeng 475000,Henan Province,China;Department of Radiology,Kaifeng Children's Hospital,Kaifeng 475000,Henan Province,China)

机构地区：[1]开封市儿童医院新生儿科,河南开封475000 [2]开封市儿童医院放射科,河南开封475000

出　　处：《中国CT和MRI杂志》2025年第4期17-20,共4页Chinese Journal of CT and MRI

基　　金：2024年度开封市科技发展计划项目(2403070)。

摘　　要：目的研究头颅磁共振成像(MRI)联合血清S-100蛋白、神经元特异性烯醇化酶(NSE)对高胆红素血症新生儿脑损伤诊断价值。方法选取医院在2019年1月至2024年3月期间收治的97例高胆红素血症新生儿为研究对象,患者均行MRI检查及血清S-100蛋白、NSE检测,对患儿临床资料进行回顾性分析。根据患者有无并发脑损伤分为发生组(n=23)和未发生组(n=74),采用多因素Logistic回归模型分析高胆红素血症新生儿出现脑损伤的危险因素。随后采用受试者工作特征(ROC)曲线分析头颅MRI参数联合血清S-100蛋白、NSE对高胆红素血症新生儿脑损伤的诊断价值。结果两组胎龄、患儿性别以及产妇分娩方式、合并妊娠高血压、合并妊娠糖尿病方面比较差异无统计学意义(P>0.05);低出生体重儿、非母乳喂养、母亲年龄≥35岁的高胆红素血症新生儿脑损伤发生率更高(P<0.05);发生组患儿G/P值、血清S-100蛋白、血清NSE高于未发生组(P<0.05)。低出生体重儿、非母乳喂养、母亲年龄≥35岁、高水平G/P值、高水平血清S-100蛋白、高水平血清NSE是高胆红素血症新生儿出现脑损伤的独立危险因素。G/P值、血清S-100蛋白、血清NSE及三者联合诊断高胆红素血症新生儿出现脑损伤的曲线下面积(AUC)分别为0.878、0.863、0.830、0.881,敏感度分别为82.61、78.26、82.43、91.30%,特异性分别为85.14、83.78、82.43、78.38%。结论头颅MRI参数G/P值、血清S-100蛋白、血清NSE的异常升高均是高胆红素血症新生儿出现脑损伤的独立危险因素,头颅MRI联合血清S-100蛋白、NSE对高胆红素血症新生儿脑损伤具有较高的诊断价值。Objective To study the diagnostic value of cranial magnetic resonance imaging(MRI)combined with serum S-100 protein and neuron-specific enolase(NSE)on brain injury in neonates with hyperbilirubinemia.Methods 97 neonates with hyperbilirubinemia in the hospital were selected from January 2019 to March 2024 as the research subjects,and received MRI examination and serum S-100 protein and NSE detection.The clinical data of the children were retrospectively analyzed.According to the presence or absence of brain injury,the patients were divided into occurrence group(n=23)and non-occurrence group(n=74).Multivariate Logistic regression model was used to analyze the risk factors of brain injury in neonates with hyperbilirubinemia.Subsequently,receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of cranial MRI parameters combined with serum S-100 protein and NSE on brain injury in neonates with hyperbilirubinemia.Results There were no statistical differences in gestational age,gender of children,delivery mode of puerperae,gestational hypertension and gestational diabetes mellitus between groups(P>0.05).The incidence rate of brain injury was higher in neonates with low birth weight,non-breastfeeding,and maternal age≥35 years old(P<0.05).The G/P value,serum S-100 protein and serum NSE in occurrence group were higher than those in non-occurrence group(P<0.05).Low birth weight infants,nonbreastfeeding,maternal age≥35 years old,high G/P value,high serum S-100 protein and high serum NSE were independent risk factors for brain injury in neonates with hyperbilirubinemia.The areas under the curves(AUCs)of G/P value,serum S-100 protein,serum NSE and their combination in the diagnosis of brain injury in neonates with hyperbilirubinemia were 0.878,0.863,0.830 and 0.881,the sensitivities were 82.61,78.26,82.43 and 91.30%,and the specificities were 85.14,83.78,82.43 and 78.38%respectively.Conclusion The abnormal increases of cranial MRI parameters G/P value,serum S-100 protein and serum NSE are ind

关 键 词：磁共振成像 神经元特异性烯醇化酶 高胆红素血症 新生儿 脑损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学]