高胆红素血症对新生儿血清神经元特异性烯醇化酶及神经行为的影响

摘要

Objective To investigate the relationship among serum neuron-specific enolase(NSE) ,to-tal serum bilirubin and neurological behavior in neonates with hyperbilirubinemia .Methods A total of 86 ca-ses of newborn hyperbilirubinemia were included in the boservation group ,while 86 normal term newborns were choose as the control group .Enzyme-linked immunosorbent assay was used to determine serum concen-tration of NSE and total serum bilirubin .NBNA score was also determined .Results The serum concentra-tions of NSE and TSB in the observation group were significantly higher than those in the control group (P<0 .01);two indicators decreased significantly after treatment .NBNA scores were significantly lower than the control group(P<0 .01);After treatment they increased and were close to normal .NSE serum concentration and NBNA score showed a significant negative correlation (P<0 .01) ,but it was positively correlated with the TSB concentration .Conclusion Serum NSE is significantly higher in the hyperbilirubinemia neonates than in the normal ones ,which can be an indicator for early prediction of neonatal bilirubin brain injury ;Hy-perbilirubinemia has some influence on neonatal neurobehavior .%目的：观察高胆红素血症新生儿血清神经元特异性烯醇化酶（NSE）、血清总胆红素（TSB）和新生儿神经行为间的相互影响及临床意义。方法86例轻中度高胆血红素血症患儿作为观察组，86例正常足月新生儿为对照组。两组在正常喂养的基础上，观察组给予茵栀黄口服液治疗，并根据黄疸程度给予蓝光照射、新生儿抚触、婴儿游泳、运动训练等；对照组仅给予常规的抚触及游泳、运动等。应用酶联免疫吸附法检测新生儿血清中 NSE、TSB含量，并行神经行为能力测定（NBNA ）评分。结果观察组血清NSE、TSB含量均较对照组显著升高，差异有统计学意义（P＜0．05），治疗后两项指标明显下降，观察组NBNA评分值均明显低于对照组，差异有统计学意义（P＜0．05），治疗后组间增高并接近正常值。血清NSE与NBNA评分呈负相关，与TSB呈正相关。结论高胆红素血症新生儿血清中NSE明显高于正常新生儿，可作为早期预测新生儿胆红素脑损伤风险的敏感指标，轻中度高胆红素血症对新生儿神经行为有一定影响。