上海医学
上海醫學
상해의학
SHANGHAI MEDICAL JOURNAL
2001年
4期
233-235
,共3页
神经元特异性稀醇化酶%S-100蛋白%髓鞘碱性蛋白%肌酸磷酸激酶脑型同工酶%新生儿、缺氧缺血性脑病
神經元特異性稀醇化酶%S-100蛋白%髓鞘堿性蛋白%肌痠燐痠激酶腦型同工酶%新生兒、缺氧缺血性腦病
신경원특이성희순화매%S-100단백%수초감성단백%기산린산격매뇌형동공매%신생인、결양결혈성뇌병
目的评价缺氧缺血性脑病(HIE)新生儿脑脊液(CSF)和血浆中神经元特异性稀醇化酶(NSE)、S-100蛋白(S-100 protein，S-100)、髓鞘碱性蛋白(MBP)、肌酸磷酸激酶脑型同工酶(CK-BB)等神经系统特异性蛋白质与新生儿HIE程度及预后的关系。方法新生儿HIE患儿55例，无中枢神经系统疾患的患儿16例作为对照，取CSF和血浆检测上述4种神经系统特异性蛋白质水平。NSE、S-100、MBP用放射免疫试剂盒检测，CK-BB用酶法及琼脂糖电泳法检测。存活出院的患儿定期随访。结果CSF的NSE、S-100、MBP、CK-BB及血浆NSE、CK-BB均与HIE程度相关，但只有CSF的神经系统特异性蛋白质才能较准确地反映患儿的远期预后，其中敏感性、特异性最高的指标是NSE和S-100。结论CSF的NSE和S-100是判断HIE患儿脑损伤程度、预测远期预后的可靠指标。
目的評價缺氧缺血性腦病(HIE)新生兒腦脊液(CSF)和血漿中神經元特異性稀醇化酶(NSE)、S-100蛋白(S-100 protein，S-100)、髓鞘堿性蛋白(MBP)、肌痠燐痠激酶腦型同工酶(CK-BB)等神經繫統特異性蛋白質與新生兒HIE程度及預後的關繫。方法新生兒HIE患兒55例，無中樞神經繫統疾患的患兒16例作為對照，取CSF和血漿檢測上述4種神經繫統特異性蛋白質水平。NSE、S-100、MBP用放射免疫試劑盒檢測，CK-BB用酶法及瓊脂糖電泳法檢測。存活齣院的患兒定期隨訪。結果CSF的NSE、S-100、MBP、CK-BB及血漿NSE、CK-BB均與HIE程度相關，但隻有CSF的神經繫統特異性蛋白質纔能較準確地反映患兒的遠期預後，其中敏感性、特異性最高的指標是NSE和S-100。結論CSF的NSE和S-100是判斷HIE患兒腦損傷程度、預測遠期預後的可靠指標。
목적평개결양결혈성뇌병(HIE)신생인뇌척액(CSF)화혈장중신경원특이성희순화매(NSE)、S-100단백(S-100 protein，S-100)、수초감성단백(MBP)、기산린산격매뇌형동공매(CK-BB)등신경계통특이성단백질여신생인HIE정도급예후적관계。방법신생인HIE환인55례，무중추신경계통질환적환인16례작위대조，취CSF화혈장검측상술4충신경계통특이성단백질수평。NSE、S-100、MBP용방사면역시제합검측，CK-BB용매법급경지당전영법검측。존활출원적환인정기수방。결과CSF적NSE、S-100、MBP、CK-BB급혈장NSE、CK-BB균여HIE정도상관，단지유CSF적신경계통특이성단백질재능교준학지반영환인적원기예후，기중민감성、특이성최고적지표시NSE화S-100。결론CSF적NSE화S-100시판단HIE환인뇌손상정도、예측원기예후적가고지표。
Objective To determine some specific proteins of the nervous system such as the neuron-specific enolase (NSE), S-100 protein (S-100), myelin basic protein (MBP) and creatine kinase isoenzyme BB (CK-BB) in cerebrospinal fluid (CSF) and plasma of asphyxiated newborns during early stage of hypoxic-ischemic encephalopathy (HIE), and its correlation with the severity of the disease and long-term outcome. Methods 71 full-term and near full-term neonates were enrolled in the study. 16 babies without neurological disease were assigned to the control group. Another 55 babies were in the HIE group. Among them, there were 20 with mild HIE, 28 with moderate,and 7 with severe HIE. CSF and plasma specimens were obtained at 9-92 hours (mean: 33.5 hours) postnatal in the HIE group. NSE/S 100/MBP were measured by immunoradiometric assay, CK-BB by agarose electrophoresis. Babies with HIE were followed-up after discharged from the hospital. Neurological outcome was assessed by physical examination and Gesell developmental diagnosis. Results 80％ (41/51) of the infants survived at the time of discharge were followed-up for 3～13 months (mean:6.5 months). 25 infants were normal, 9 slightly abnormal, and 7 seriously abnormal. Although the plasma levels of NSE, and CK-BB correlated with the degree of HIE, they could not predict accurately the long-term outcome. NSE, S-100, MBP and CK-BB in CSF were correlated not only to the severity of the disease, but also to the long-term outcome. Among the four markers, NSE and S-100 were the most sensitive and specific in the prediction of the degree of brain injury. Conclusion NSE and S-100 in CSF are the most reliable markers for early estimation of the degree of HIE in neonates. (Shanghai Med J, 2001,24:233-235)
