摘要
目的研究新生儿血清神经组织蛋白质S-100β(S-100β)和神经元特异性烯醇化酶(neuronspecific endase)含量对于新生儿缺氧缺血性脑病(HIE)诊断和预后判断的临床价值。方法新生儿NSE患儿60例(轻度组34例,中等度组7例,重度组9例)和对照组30例,在出生12 h之内,取静脉血检测血S-100β、NSE。评估做出HIE诊断的临床意义,并跟踪半年以上,观察预后结果,对血清S-100β和NSE含量检测结果与新生儿HIE诊断结果和新生儿HIE及预后结果之间的关系进行ROC分析。结果对照组、HIE轻度组、HIE中度组和HIE重度组的NSE分别为均(8.1±1.3)μg/L,(37.7±15.6)μg/L,(59.3±18.9)μg/L,(76.3±19.6)μg/L,4组间差异均有统计学意义(P<0.01);对照组、HIE轻度组、HIE中度组和HIE重度组的S-100分别为均(0.15±0.08)μg/L,(0.71±0.31)μg/L,(0.98±0.24)μg/L,(1.37±0.60)μg/L,4组间差异均有统计学意义(P<0.01);新生儿在出生后12 h内的血清S-100β含量>0.635μg/L,可以诊断HIE,灵敏度为73.3%,特异性为86.7%;高于0.86μg/L,其结果可能为脑性瘫痪或死亡,灵敏度为85.7%,特异性为86.8%。血清NSE含量>33.76μg/L,可以诊断HIE,灵敏度为75%,特异性为96.7%;高于58.045μg/L,其结果可能为脑性瘫痪或死亡,灵敏度为92.9%,特异性为93.4%。结论S-100β和NSE可作为新生儿HIE诊断和预后判断的指标。
Objective To investigate the clinical significance of S-100β and NSE in diagnosis and prognosis of HIE in neonates. Methods 60 patients with HIE divided into three groups, light degree group （ n = 34）, moderate degree group （ n = 17）, severe degree group （ n =9）, and 30 healthy subjects were used as controls（control group）. NSE and S-100β were measured in four groups within 12 h of birth. The newborns were diagnosed for HIE and follow-up was performed for 6 months during which the patients＇ outcomes were evaluated. The relationship wase evaluated using ROC analysis between the S-100β concentration and corresponding diagnosis and prognosis. Results The newborns with a serum S- 100β concentration more than 0. 635μg/L within 12 h of birth developed HIE with a sensitivity of 73.3 % and a specificity of 86.7 %. A serum S-100β concentration more than 0.86 μg/L predicted cerebral palsy or death with a sensitivity of 85.7% and a specificity of 86.8%. The newborns with a serum NSE concentration more than 33.76 μg/L within 12 h of birth developed HIE with a sensitivity of 75% and a specificity of 96.7%. A serum NSE concentration more than 58. 045 μg/L predicted cerebral palsy or death with a sensitivity of 92.9% and a specificity of 93.4%. Conclusion ,Serum S-100β and NSE can be a clinically practical and auxiliary biochemical maker for the diagnosis and prognosis of HIE in neonates.
出处
《河北医药》
CAS
2009年第1期17-18,共2页
Hebei Medical Journal
基金
河北省科技厅科技攻关项目(编号:03276403D-10)
