缺氧缺血性脑病新生儿血清神经元特异性烯醇化酶浓度动态变化的意义［摘要］目的探讨新生儿窒息后缺氧缺血性脑病(HTE)患儿血清神经元特异性烯醇化酶(NSE)的动态变化及意义。方法收集2005年1月〜2012年12月住院治疗的足月窒息新生儿75例(窒息组)和健康足月新生儿50例(对照组)，采用酶联免疫吸附试验法检测两组新生儿出生后1、3、7d时血清NSE浓度变化，并分析英变化与窒息后HIE的关系。结果出生后1、3、7d,窒息组新生儿血清NSE浓度均明显高于对照组［(44.50±12.08)ug/Lvs(15.59±6.25)ug/L,(42.65±12.43)ng/Lvs(15.38±5.84)ug/L,(37.90±9.50)ug/Lvs(13.92±5.37)ug/L］,差异有统计学意义(P<0.05)o重度窒息新生儿血清NSE浓度明显高于轻度窒息新生儿［(5&95±14.85)ug/Lvs(29.15±9.32)Pg/L,(62.95±19.13)ug/Lvs(22.35±5.75)ug/L,(57.35±13.75)Ug/Lvs(1&45±5・25)ug/L］,差异有统计学意义(P〈0・05)。出生后1、3、7d,HIE新生儿19例血清NSE浓度逐渐升高，而MRI正常新生儿56例血清NSE浓度逐渐下降,HIE新生儿血清NSE浓度均明显高于MRI正常新生儿［(59.84±15.09)ug/Lvs(32.95±12.86)ug/L,(63.95±19.21)ng/Lvs(25.73±6.75)ng/L,(68.25±19.79)ug/Lvs(19.62±5.94)ng/L］,差异有统计学意义(P〈0・05)。结论监测血清NSE浓度动态变化冇助于早期辅助判断窒息新生儿HlEo［关键词］窒息，新生儿；缺氧缺血性脑病；神经元特异性烯醇化酶［中图分类号］R722.1［文献标识码］A［文章编号］1674-4721(2014)06(a)-0065-03Significanceofthevariationsofserumneuron-specificenolaselevelinhypoxic-ischemicencephalopathyneonatorumYANCMeiWANGuang-pingLIUFangYANGJieCAOXiaYANGJinDepartmentofNeonataiIntensiveCareUnit,MeishanPeople'sllospitaiofSichuanProvince,Meishan620010,China[Abstract]ObjectiveTostudythesignificanceofthevariati()nsofserumneuronspecificenolase(NSE)levelinhypoxic~ischemicencephalopathy(HTE)neonatorum.MethodsTheserumNSElevelweredetectedin75asphyxianeonatorum(asphyxiagroup)and20normalneonatomm(controlgroup)bythemethodofELISAafterparturition1,3and7days.TherelationofserumNSElevelandhypoxicischemicencephalopathywasanalyzed.ResultsAfterparturition1,3and7days,theserumNSElevelinasphyxiagroupwashigherthanthatincontrolgroup[(44.50±12.08)ug/Lvs(15.59±6.25)Pg/L,(42.65±12.43)Ug/Lvs(15.38±5.84)Ug/L,(37.90±9.50)ug/Lvs(13.92±5.37)ug/L],therehadsignificsntdifference(P<0.05).TheserumNSElevelinseverasphyxiagroupwashigherthanthatinmi1dasphyxiagroup[(58.95±14.85)ug/Lvs(29.15±9.32)ug/L,(62.95+19.13)ug/Lvs(22.35±5.75)ug/L,(57.35±13.75)Ug/Lvs(18.45±5.25)Ug/L],therehadsignificantdifference(P<0.05).Afterparturition1,3and7d,theserumNSE1evelinHTEneonatorum(19cases)wasincreasedandinMRInormalneonatorum(56cases)wasdecreased,theserumNSElevelinHIEneonatorumwashigherthanthatinMRInonnalneonatorum[(59.84+15.09)ug/Lvs(32.95+12.86)Pg/L,(63.95±19.21)ug/Lvs(25.73±6.75)ug/L,(68.25±19.79)Ug/Lvs(19・62±5.94)ug/L],therehadsignificantdifference(P<0.05).ConclusionThevariationsofserumNSElevelcanbetheimportantindicatortomonilorHIEinasphyxianeonatorum.[Keywords]Asphyxianeonatorum;Hypoxic-ischemicencephalopathy;Neuron-specificenolase近年来，缺氧缺血性脑病(hypoxic-ischemicencephalopathy,HIE)在新生儿疾病中较为常见，该病严重影响患儿的脑部功能发育且致残率高，有40%〜50%的患儿死亡或留下严重的神经系统后遗症，如脑瘫、吞咽困难、认知缺陷、视觉损伤、惊厥、癫痫、睡眠障碍、智力低下等[1],早期诊断、早期干预是治疗窒息后HIE、降低围生期病死率的关键，因此,寻找简便、安全、准确有效的客观指标对窒息后脑损伤的判定，对降低新生儿窒息后的病死率及伤残率，提高生存质量冇重要意义。大量动物及临床试验已经证实，神经元特异性烯醇化酶（neuron-specificenolas...