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目的探讨早产儿脑白质损伤(WMD)早期肌酸激酶脑型同功酶(CK-BB)及神经元特异性烯醇化酶(NSE)的动态变化。方法选择我科2011年1～10月临床资料完整、胎龄<34周的早产儿病例,患儿均在出生后24、72、120h采静脉血,应用酶联免疫吸附法检测CK-BB,化学发光法检测NSE。根据颅脑彩超检查结果,发生WMD者为观察组,无WMD者为对照组。结果观察组(18例)生后24、72、120hCK-BB含量(mg/L)均高于对照组(53例)[24h:(87.6±14.3)比(68.2±22.0),72h:(77.4±12.7)比(61.1±17.4),120h:(65.5±14.0)比(51.2±14.8),P均<0.05];生后24hNSE含量(mg/L)高于对照组[(81.8±14.3)比(52.6±21.9),P<0.01],72、120h两组差异无统计学意义(P均>0.05)。结论 WMD早产儿生后24h内CK-BB、NSE均明显升高,对诊断WMD具有一定指导意义,CK-BB升高持续时间长,生后72、120h仍有一定诊断意义,而NSE持续时间短,生后72、120h时对诊断WMD无指导意义。
Objective To investigate the dynamic changes of creatine kinase (CK-BB) and neuron-specific enolase (NSE) in preterm infants with early white matter damage (WMD). Methods The clinical data of our department from January to October in 2011 with complete gestational age <34 weeks were collected. Venous blood was collected at 24, 72 and 120 h after birth in children. Serum CK-BB was detected by enzyme linked immunosorbent assay (ELISA) Chemiluminescence detection of NSE. According to cranial color Doppler ultrasound examination results, the occurrence of WMD were observed group, no WMD were the control group. Results The levels of CK-BB at 24, 72 and 120 h after treatment in the observation group (18 cases) were significantly higher than those in the control group (53 cases) at 24 h, 72 h and 120 h after the operation [24 h (87.6 ± 14.3) vs 68.2 ± 22.0 (61.1 ± 17.4), 120h: (65.5 ± 14.0) vs (51.2 ± 14.8), P <0.05 respectively. The content of NSE (mg / L) was significantly higher than that of the control group [(81.8 ± 14.3) (52.6 ± 21.9), P <0.01]. There was no significant difference between the two groups at 72 and 120h (P> 0.05). CONCLUSION: The levels of CK-BB and NSE in preterm infants with WMD are significantly increased within 24 hours after birth, which may be of guiding significance in the diagnosis of WMD. The duration of CK-BB increase is still long before 72 and 120 hours after birth, while the duration of NSE Short, 72,120 h after birth when the diagnosis of WMD no guiding significance.