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目的研究新生儿特异性烯醇化酶(NSE)与新生儿高胆红素血症之间的关系,以探讨高胆红素血症新生儿脑损害早期诊断的客观依据。方法利用放免法对124例高胆红素血症足月新生儿及40例正常足月新生儿进行血清NSE测定,对81 例NSE升高的新生儿进行脑干听觉诱发电位(BAEP)测试,并于生后12-18个月进行智能测定。结果NSE水平在胆红素重度升高、中度升高、轻度升高组均增高,与对照组之间差异有显著性,P<0.01。BAEP异常率、智能发育指数(PDI)及运动发育指数(MDI)下降在轻度升高组与对照组、重度升高组与中度升高组之间差异有显著性,但在轻度升高组与中度升高组之间差异无显著性。结论NSE水平的测定较以BAEP及智能测定来判断新生儿高胆红素脑损害更早、更敏感,NSE可作为判断高胆红素血症新生儿发生脑损害早期预后指标之一。
Objective To study the relationship between neonatal specific enolase (NSE) and neonatal hyperbilirubinemia and to explore the objective evidence of early diagnosis of neonatal cerebral injury with hyperbilirubinemia. Methods Serum NSE was measured in 124 neonates with full bilirubinemia and 40 normal term neonates by radioimmunoassay. Eighty-one neonates with elevated NSE were tested for brainstem auditory evoked potential (BAEP) And 12-12 months after birth, intelligent determination. Results The level of NSE was significantly increased in bilirubin, moderately elevated and mildly elevated group, with significant difference (P <0.01). The abnormal rate of BAEP, PDI and MDI decreased between the mildly elevated group and the control group, but there was a significant difference between the moderately elevated group and the moderately elevated group There was no significant difference between high group and moderate increase group. Conclusion The determination of NSE level is earlier and more sensitive than that of BAEP and intelligent measurement in judging neonatal hyperbilirubine brain damage. NSE can be used as one of the early prognostic indicators for judging the brain damage of newborns with hyperbilirubinemia.