缺氧缺血性脑病新生儿血清及脑脊液神经元特异性烯醇化酶水平变化的意义被引量：13

Changes of Neuron-Specific Enolase Levels in Serum and Cerebrospinal Fluid of Neonates with Hypoxic-Ischemic Encephalopathy and Its Clinical Significance

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摘要目的探讨血清和脑脊液（CSF）神经元特异性烯醇化酶（NSE）水平变化在缺氧缺血性脑病（HIE）新生儿中的意义。方法常规留取重度窒息足月新生儿生后12～24h和HIE恢复期血清和CSF标本，同时留取正常足月新生儿血清标本作对照，采用免疫放射分析法（IRMA）对符合纳入标准的41例HIE和10例正常足月新生儿的标本进行NSE水平检测。患儿均按常规进行监护和治疗。结果1．急性期HIE各组及对照组患儿血清NSE水平[分别为（30．81±4．55）、（43．63±8．20）、（62．13±17.55）、（21.85±2．53）μg／L]间均有显著性差异（F=30.98 P〈0.01），且HIE程度越重，NSE水平越高（P〈0．01）；2．对照组与轻、中、重度HIE恢复组患儿血清NSE水平差异无显著性[分别为（15.35±4．59）、（19．92±6．29）、（20．92±7．58）、（23．65±9．50）μg／L）]（F=2．41 P〉0．05），重度HIE未恢复组患儿血清NSE水平[（77．03±20.94）μg／L]仍明显高于其他组，差异有极显著意义（P〈0.01）；3．HIE组患儿血清与CSF中NSE水平呈明显正相关（r=0．81 P〈0．01）。结论血清NSE水平的变化用于判断新幸儿HIE的发牛及程序有首要的参考意义． Objective To investigate the changes of neuron （CSF） of neonates with hypoxic- ischernic encephalopathy（HIE） - specific enolase （NSE） levels in both serum and cerebrospinal fluid Methods CSF and serum samples were studied in asphyxiated termnewbrom infants. Some in postnatal 12 - 24 hours and the others within postnatal 10 - 12 days as the symptoms and signs of HIE were developed while only serum sarnples were obtained from neonates in healthy term as controls. The NSE levels of 41 cases of HIE and 10 cases of health term neonates were undergone by immunoradiornetric assay（IRMA） testing according to inclusion criteria. All cases were routinely monitored and received accordingly treatment. Results 1. A significant difference was shown in serum NSE levels between HIE groups[ （30.81 ± 4.55） μg/L for mild, （43.63 ± 8.20）μg/L for moderate and （62.13 ± 17.55） μg/L for severe groups ] in acute phase （ postnateal 12 - 24 hours） and control group[ （ 21.85 ± 2.53 ）μg/L] （ all P 〈 0.01 ）, and the more severe of HIE was the higher of NSE level（ P 〈 0.01 ）. 2. During recovery（ postnateal 10 - 12 days）, no significant difference of serum NSE levels was shown between control group [ （ 15.35 ± 4.59）μg/L ] and mild[ （ 19.92 ± 6.29） μg/L], moderate[ （ 20.92 ± 7.58） μg/L ] HIE groups while for severe HIE group , whose neurological symptorns and signs had not been recovered [ （ 23.65 ± 9.50） μg/L ] （F=2.41 P〈 0.05）, level of HIE staying was higher than that of other groups and the differences rum to be statistically significant（ P〈 0.01 ）. 3. NSE levels in serum Were positively correlated with that in CSF for HIE cases （ r = 0.81 P 〈 0.05 ）. Conclusion As a biochemical indicators, the changes of serum NSE levels may play an important role for assessment of neonatal HIE.

作者白波陈波孙谷刘志军江鹏龚湛潮黄志刚

机构地区广州市花都区人民医院儿科

出处《实用儿科临床杂志》 CAS CSCD 北大核心 2006年第14期912-913,共2页 Journal of Applied Clinical Pediatrics

关键词磷酸丙酮酸水合酶缺氧缺血脑婴儿新生 phosphopyruvate hydratase hypoxic - ischemic, brain infant, newborn

分类号 R722.12 [医药卫生—儿科]

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参考文献14

1王要明.新生儿缺氧缺血性脑病的临床及头颅CT特点分析[J].蚌埠医学院学报,2006,31(2):166-167. 被引量：1
2Martens P,Raabe A,Johnsson P,et al.Serum S-100 and neuron -specific enolase for prediction of regaining consciousness after global cerebral ischemia[J].Stroke,1998,29(11):2363-2366.
3Kecskes Z,Dunster KR,Colditz PB.NSE and S-100 after hypoxia in the newborn pig[J].Pediatr Res,2005,58 (5):953-957.
4Daval JL,Pourie G,Grojean S,et al.Neonatal hypoxia triggers transient apoptosis followed by neurogenesis in the rat CA1 hippocampus[J].Pediatr Res,2004,55(4):561-567.
5Schoerkhuber W,Kittler H,Sterz F,et al.Time course of serum neuron-specific enolase.A predictor of neurological outcome in patients resuscitated from cardiac arrest[J].Stroke,1999,30 (8):1598-1603.
6Pfeifer R,Borner A,Krack A,et al.Outcome after cardiac arrest:Predictive values and limitations of the neuroproteins neuron-specific enolase and protein S-100 and the glasgow coma scale[J].Resuscitation,2005,65(1):49-55.
7Vos PE,Lamers KJ,Hendriks JC,et al.Glial and neuronal proteins in serum predict outcome after severe traumatic brain injury[J].Neurology,2004,62(8):1303-1310.
8Bandyopadhyay S,Hennes H,Gorelick MH,et al.Serum neuron-specific enolase as a predictor of short-term outcome in children with closed traumatic brain injury[J].Acad Emerg Med,2005,12 (8):732-738.
9Celtik C,Acunas B,Oner N,et al.Neuron-specific enolase as a marker of the severity and outcome of hypoxic ischemic encephalopathy[J].Brain Dev,2004,26(6):398-402.
10刘振玲,杜华,刘振翔.病毒性脑炎患儿脑脊液和血清神经元特异性烯醇酶测定的临床意义[J].实用儿科临床杂志,2004,19(1):59-60. 被引量：10

二级参考文献28

1周丛乐,虞人杰.新生儿缺氧缺血性脑病影像学诊断特点[J].中国实用儿科杂志,1995,10(2):74-76. 被引量：88
2朱凤莲,郭学鹏,钱惠茵.新生儿缺氧缺血性脑病脑脊液神经元特异性烯醇化酶测定的临床意义[J].实用儿科临床杂志,1996,11(5):260-262. 被引量：4
3韩玉昆.新生儿缺氧缺血性脑病诊断依据和临床分度[J].中华儿科杂志,1997,35(2):99-100. 被引量：2786
4金汉珍黄德珉官希吉.实用新生儿学[M](第2版)[M].北京:人民卫生出版,1999.93-100.
5Infante JR,Torres M,Martinez A,et al.Evaluation of tumor marker S-100 in cerebrospinal fluid from subjects with nonischemic brain pathologies.Tumour Biol,2000,21(1):38-45
6Missler U,Wiesmann M,Friedrich C,et al.S-100 protein and neuron-specific enolase concentrations in blood as indicators of infarction volume and prognosis in acute ischemic stroke.Stroke,1997 Oct,28(10):1956-1960
7Rosen H,Rosengren L,Herlitz J.Increased serum levels of the S-100 protein are associated with hypoxic brain damage after cardiac arrest.Stroke,1998,29(2):473-477
8Ras mussen LS,Christiansen M,Hansen PB,et al.Do blood levels of neuron-specific enolase and S-100 protein reflect cognitive dysfunction after coronary artery bypass? Acta Anaesthesiol Scand,1999,43(5):495-500
9董如训梁秀龄刘焯霖.临床神经病学[M].北京：人民卫生出版社,1996.282.
10Tatemoto K, Carlquist M, Mutt V. Neuropeptide Y-a novel brain peptide with structural similarities to peptide YY and pancreatic polypeptide [J]. Nature, 1982, 296(5858): 659 - 660.