血清NSE LDH及CRP水平动态检测在新生儿缺氧缺血性脑病病情评估中的临床意义

摘要

目的：探讨血清神经元特异性烯醇化酶（NSE）、乳酸脱氢酶（LDH）及C反应蛋白（CRP）水平动态检测在新生儿缺氧缺血性脑病病情评估中的临床意义。方法随机选取2010年1月至2015年2月315例新生儿缺氧缺血性脑病患儿，设为观察组，另选取分娩的70例足月健康新生儿作为对照组，运用放射免疫法测定血清NSE；运用酶法测定血清LDH；运用免疫比浊法测定血清CRP。结果观察组患儿的血清NSE、LDH水平均显著高于对照组差异有统计学意义（P<0.05），但两组新生儿的血清CRP水平之间的差异不显著（P>0.05）；组内比较，观察组中轻度、中度、重度的血清NSE、LDH水平均逐渐降低（P<0.05），血清CRP水平先升高后降低（P<0.05）；组间比较，观察组患儿出生后7d的血清NSE、LDH及CRP水平均显著高于对照组（P<0.05），但出生后10d两组新生儿的血清NSE、LDH及CRP水平之间的差异均不显著（P>0.05）。患儿病情严重程度和血清NSE、LDH水平呈显著正相关关系（P<0.05），和血清CRP水平之间无相关性（P>0.05）。结论血清NSE、LDH水平动态检测能够有效评估新生儿缺氧缺血性脑病病情。%Objective To investigate the changes of serum neuron specific enolase(NSE),lactate dehydrogenase(LDH)and C reactive protein(CRP)clinical significance of dynamic detection of disease in neonatal hypoxic ischemic encephalopathy assessment. Methods 315 cases of neonatal hypoxic-ischemic encephalopathy from January 2010 to February 2015 were randomly selected as the observation group,70 cases of full-term select another newborn delivery as control group,serum NSE was determined by radioimmunoassay; Determination of serum LDH by enzyme method; using immune turbidimetric method to determine serum CRP. Results in the observation group the serum NSE,LDH levels were significantly higher than those in the control group(P<0.05),but there was no significant difference between the level of serum CRP in two groups.(P>0.05);the comparison group,the observation group in mild,moderate,severe serum NSE,LDH levels were gradually decreased(P<0.05),the serum level of CRP increased first and then decreased(P<0.05); groups,to observe the groups of children born after 7 days of serum NSE,LDH and CRP levels were significantly higher than those of control group(P<0.05),but for those neonates born after 10d, the serum NSE. LDH and CRP levein the two groups were not significantly different(P>0.05). In children with the disease severity and serum NSE,LDH levels showed significant positive correlation(P<0.05),and for serum levels of C-reactive protein(CRP)there was no correlation between(P>0.05). Conclusion Serum NSE, LDH level dynamic detection can effectively assess neonatal hypoxic ischemic encephalopathy(HIE)condition.