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目的观察新生儿缺氧缺血性脑病 ( HIE)血清神经元特异性烯醇化酶 ( NSE)变化 ,评价其对新生儿 HIE病情严重程度和转归判断的临床意义。方法对 48例新生儿 HIE患儿生后 3天、7天血清 NSE进行检测。其中 40例 1周内行脑 CT检查。另选 2 0例同期住院无神经系统症状及体征 ,出生时无窒息的新生儿作为对照组。结果在生后 3日无论临床或者 CT诊断的 HIE患儿血清神经元特异性烯醇化酶浓度明显升高 ,中、重度 HIE患儿较对照组有显著性差异 ( P<0 .0 1) ,与临床及 CT分度一致。生后 7天轻、中度 HIE患儿血清 NSE基本正常 ,尽管重度 HIE患儿血清 NSE仍高于正常 ,但已显著低于 3天时水平 ,下降趋势与临床表现一致。结论血清神经元特异性烯醇化酶动态测定可作为早期诊断 HIE及判断脑损伤程度及预后的特异性指标。
Objective To observe the changes of serum neuron specific enolase (NSE) in neonates with hypoxic-ischemic encephalopathy (HIE) and evaluate the clinical significance of the severity of HIE and the prognosis of newborn infants. Methods Serum NSE was detected in 48 neonates with HIE at 3 days and 7 days after birth. 40 cases of brain CT examination within 1 week. Another 20 cases of hospitalized with no neurological symptoms and signs of the same period, no neonatal asphyxia at birth as a control group. Results Serum levels of neuron specific enolase (NSE) were significantly increased in both HIE and neonates with HIE at 3 days after birth. There was significant difference between the moderate and severe HIE children in the control group (P <0.01) Consistent with clinical and CT indexing. Serum NSE was normal in mild and moderate HIE children 7 days after birth. Although the serum NSE in children with severe HIE was still higher than normal, it was significantly lower than that at 3 days, and the downward trend was consistent with the clinical manifestations. Conclusion The dynamic determination of serum neuron-specific enolase can be used as a specific index for early diagnosis of HIE and judging the degree of brain injury and prognosis.