哈尔滨医科大学学报
哈爾濱醫科大學學報
합이빈의과대학학보
JOURNAL OF HARBIN MEDICAL UNIVERSITY
2009年
6期
593-595
,共3页
神经元特异性烯醇化酶%缺氧缺血性脑病%纳络酮
神經元特異性烯醇化酶%缺氧缺血性腦病%納絡酮
신경원특이성희순화매%결양결혈성뇌병%납락동
neuron specific enolase%hypoxic ischemic encephalopathy%naloxone
目的 动态观察神经元特异性烯醇化酶(NSE)在新生儿缺氧缺血性脑病(HIE)时及纳络酮治疗前后水平的变化,以探讨在临床中的意义.方法 测定98例HIE患儿于生后24 h、4天、7天及纳络酮治疗前后血清中NSE浓度,并进行比较.结果 ①重度HIE组血清NSE水平高于中度组,中度组高于轻度组,差异具有显著性(P<0.05),轻度组与对照组比较,差异无显著性(P>0.05).②除对照组外,HIE各组血清NSE含量在第4天时明显升高,而在第7天时显著下降(P<0.05);与对照组相比,轻度HIE组NSE第7天接近正常(P>0.05)中度和重度组未达到正常值(P<0.05).③纳络酮治疗组较常规治疗组NSE含量显著降低(P<0.05).结论 ①HIE时血清中NSE含量明显增高,且其升高程度与病情危重程度密切相关.②纳络酮治疗HIE患儿可稳定神经元细胞膜,减少细胞凋亡,从而减少NSE的释放.③应在HIE发生后的4日以内尽早使用纳络酮,以更好地发挥神经保护作用.
目的 動態觀察神經元特異性烯醇化酶(NSE)在新生兒缺氧缺血性腦病(HIE)時及納絡酮治療前後水平的變化,以探討在臨床中的意義.方法 測定98例HIE患兒于生後24 h、4天、7天及納絡酮治療前後血清中NSE濃度,併進行比較.結果 ①重度HIE組血清NSE水平高于中度組,中度組高于輕度組,差異具有顯著性(P<0.05),輕度組與對照組比較,差異無顯著性(P>0.05).②除對照組外,HIE各組血清NSE含量在第4天時明顯升高,而在第7天時顯著下降(P<0.05);與對照組相比,輕度HIE組NSE第7天接近正常(P>0.05)中度和重度組未達到正常值(P<0.05).③納絡酮治療組較常規治療組NSE含量顯著降低(P<0.05).結論 ①HIE時血清中NSE含量明顯增高,且其升高程度與病情危重程度密切相關.②納絡酮治療HIE患兒可穩定神經元細胞膜,減少細胞凋亡,從而減少NSE的釋放.③應在HIE髮生後的4日以內儘早使用納絡酮,以更好地髮揮神經保護作用.
목적 동태관찰신경원특이성희순화매(NSE)재신생인결양결혈성뇌병(HIE)시급납락동치료전후수평적변화,이탐토재림상중적의의.방법 측정98례HIE환인우생후24 h、4천、7천급납락동치료전후혈청중NSE농도,병진행비교.결과 ①중도HIE조혈청NSE수평고우중도조,중도조고우경도조,차이구유현저성(P<0.05),경도조여대조조비교,차이무현저성(P>0.05).②제대조조외,HIE각조혈청NSE함량재제4천시명현승고,이재제7천시현저하강(P<0.05);여대조조상비,경도HIE조NSE제7천접근정상(P>0.05)중도화중도조미체도정상치(P<0.05).③납락동치료조교상규치료조NSE함량현저강저(P<0.05).결론 ①HIE시혈청중NSE함량명현증고,차기승고정도여병정위중정도밀절상관.②납락동치료HIE환인가은정신경원세포막,감소세포조망,종이감소NSE적석방.③응재HIE발생후적4일이내진조사용납락동,이경호지발휘신경보호작용.
Objective To observe the changes of blood neuron specific enolase (NSE) in neonates with hypoxic ischemic encephalopathy.(HIE),meanwhile,to explore therapeutic effects and Dossible mechanism of naioxone,and provide theoretical and practical basis for the treatment of HIE.Methods The levels of NSE were examined in treatment and control groups on the 1 st、4th day and 7th day after birth.Results NSE in the severe HIE group were obviously higher than those in the mild and moderate HIE group(P<0.05).No difference was found between the mild and control groups(P>0.05).The levels of NSE in HIE groups on the 4th day after birth were higher than those on the 1 st day(P<0.05),and lower on the 7th day after birth,but still higher than those in the control group(P<0.05).The NSE levels of the treatment group with naloxone were reduced than that of the treatment group without naloxone significantly(P<0.05).ConclusionNSE may be involved in the occulyence and development of HIE,and its level is closely correlated with the severity of HIE.Naloxone could stabilize nerve cell membrane,reduce NSE release and should be used within 4 days in HIE cases to exert good protection effect on neuron function.
