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血清NSE在金双歧、茵栀黄及蓝光照射治疗高胆红素血症新生儿脑损伤前后的临床意义

Clinical significance of serum NSE in neonates with hyperbilirubinemia before and after golden bifid and phototherapy treatment
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摘要 目的分析血清神经元特异性烯醇化酶(NSE)含量在金双歧、茵栀黄及蓝光照射治疗前后高胆红素血症新生儿脑损伤的关系。方法对130例高胆红素血症新生儿在治疗前及治疗后分别采用酶联免疫法测定血清NSE,同时行新生儿神经行为测定(NBNA)评分及急性胆红素脑病(ABE)的胆红素致神经功能障碍(BIND)评分,按血清总胆红素(TBIL)严重程度分为试验组和对照组,试验组包括:轻度升高组(A组):205.2μmol/L<TBIL≤256.5μmol/L;中度升高组(B组):256.5μmol/L<TBIL≤342.0μmol/L;重度升高组(C组):TBIL>342.0μmol/L。对照组:金双歧、茵栀黄及蓝光照射治疗后的患儿TBIL<91.9~171.0μmol/L。比较各组高胆红素血症新生儿治疗前后血清NSE、NBNA评分及BIND评分,并对血清NSE与NBNA评分及BIND评分进行相关性分析。结果各组高胆红素血症新生儿血清NSE、NBNA评分及BIND评分治疗前后差异均具有统计学意义(Ps<0.05)。血清NSE与NBNA评分呈负相关(r=-0.869,P<0.01);血清NSE与BIND评分呈正相关(r=0.577,P<0.01)。结论血清NSE水平变化可作为高胆红素血症新生儿脑损伤的检测指标。 Objective To explore the association between hyperbilirubinemia-induced neurological dysfunction and levels of neuron-specific enolase(NSE)in newborns.Methods Full-term(n=130)newborns with hyperbilirubinemia were divided into four groups based on their blood bilirubin concentration.Serum levels of NSE were assessed using enzyme-linked immunosorbent assay(ELISA)before and after golden bifid and phototherapy treatment.Total serum bilirubin(TBIL)levels were measured according to previously published protocols and used to divide the full-term newborns into three groups,i.e.Group A with mild elevation(205.2μmol/L<TBIL≤256.5μmol/L),Group B with moderate elevation(256.5μmol/L<TBIL≤342.0μmol/L),and Group C with severe elevation(TBIL>342.0μmol/L).The control group consisted of newborns who had received phototherapy and exhibited TSB levels in the range of 91.9-171.0μmol/L.Neurological dysfunction was determined before and after phototherapy by neonatal behavioral neurological assessment(NBNA)and bilirubin-induced neurologic dysfunction(BIND)scores.And the correlation between serum NSE and scores of NBNA and BIND was analyzed.Results The levels of serum NSE and total serum bilirubin(TSB)elevated in full-term neonates with hyperbilirubinemia before phototherapy,but decreased significantly after treatment(P<0.05).NBNA and BIND scores also improved significantly following treatment(P<0.05).Serum level of NSE was negatively correlated with NBNA score,while positively correlated with BIND score.Conclusion Serum NSE levels are associated with clinical manifestations of bilirubin-induced neurotoxicity,and can be used as a reference index in clinical monitoring of neonatal hyperbilirubinemia-induced brain injury.
作者 沈向梅 蔡宇红 SHEN Xiangmei;CAI Yuhong(Department of Pediatrics,the First Affiliated Hospital of Xi′an Medical University,Xi′an,Shaanxi 710077,China)
出处 《中国微生态学杂志》 CAS CSCD 2019年第4期456-458,共3页 Chinese Journal of Microecology
关键词 高胆红素血症 脑损伤 神经元特异性烯醇化酶 NBNA评分 BIND评分 Hyperbilirubinemia Neurotoxicity Neuron-specific enolase Neonatal behavioral neurological assessment Bilirubin-induced neurologic dysfunction
作者简介 通信作者:沈向梅(1972-),女,硕士,副主任医师,从事小儿神经系统疾病及新生儿疾病研究,E-mail:shxm199288@163.com.
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