血清神经元特异性烯醇化酶及S100B蛋白水平在早期评价窒息新生儿脑损伤中意义.docVIP

血清神经元特异性烯醇化酶及S100B蛋白水平在早期评价窒息新生儿脑损伤中意义[摘要] 目的:探讨新生儿窒息后血清S100B蛋白和神经元特异性烯醇化酶(NSE)水平动态变化对诊断新生儿窒息和判断窒息后脑损伤的价值。方法:30例临床诊断为窒息的新生儿,分别于生后12 h、72 h、7 d取外周静脉血血清-70℃低温保存。用酶联免疫吸附(ELISA)方法分别检测S100B、NSE的血清浓度。以20例正常新生儿为对照组。结果:轻、重度窒息新生儿生后12 h血清NSE、S100B水平与对照组比较,差异有统计学意义(P0.05);血清S100B水平比较,差异有统计学意义(P0.05). There were significant differences between 12 h and 72 h in mild asphyxiated group and severe asphyxiated group (P 1.2 方法 1.2.1血清制备:窒息新生儿分别于生后12 h、72 h、7 d严格无菌操作下采集外周静脉血约3 ml,3 000 r/min离心,血清分装于密封无污染的试管内,-70℃保存待测。对照组正常足月顺产新生儿于生后12 h严格无菌操作下采集外周静脉血约3 ml,3 000 r/min离心,血清分装于密封无污染的试管内,-70℃保存待测。 1.2.2 窒息新生儿分别于生后5～7 d行头颅CT检查。 1.2.3 用酶联免疫吸附(ELISA)方法行NSE及血清S100B蛋白测定。 1.3 统计学处理 数据用均数±标准差(x±s)表示,采用SPSS 13.0统计软件行成组设计多个样本比较的秩和检验(Kruskal-Wallis法)和多个样本两两比较的秩和检验(Nemenyi法)。重复测量设计的方差分析、两两比较采用Bonferroni法,P0.05)。见表2。 表2 窒息新生儿NSE水平不同时间点的组间和组内比较 Tab.2 Comparison of NSE in different time points and asphyxia groups 2.1.3窒息新生儿组内各时间点(12 h、72 h、7 d)血清NSE水平比较,只有12 h和72 h两两比较,差异有统计学意义(P [4]Herrmann M, Jost S, Kvti S, et al. Temporal profile of release of neurobiochemical markers of brain damage after traumatic brain injury is associated with intracranial pathology as demonstrated in cranial computerized to tomography [J]. Neurotrauma,2000,17(2):113-122. [5]Nagdyman N, Grimmer I, Scholz T, et al. Predictive value of brain-specific proteins in serum for neurodevelopmental outcome after birth asphyxia [J]. Pediatr Res,2003,54(2):270-275. [6]Bloomfield SM, Mckinnev J, Smith L, et al. Reliability of S100B in predicting severity of central nervous system injury [J]. Neurocrit Care,2007,6(6):121-138. [7]Beger RP, Pierce Mc, Wisniewskis R, et al. Neuron-specific enolase and S100B in cerebrospinal fluid after severe traumatic brain injury in infants and children [J]. Pediateics,2002,109(2):31. [8]Woertgen C, Potheorl RD. Serum S100B protein in severe head injury [J]. Neurosurgery,2000,46(4):1026-1027. [9]王庆红,宋健辉,王霞,等.血清S100B蛋白在新生儿窒息后脑损伤中的临床意义[J].中国当代儿科杂志,200