CAJ | 학술논문

目的：观察新生儿缺氧缺血性脑病（HIE）患儿血清中S100B蛋白、神经元烯醇化酶（NSE）水平变化反映脑损伤病情程度的临床意义和1,6-二磷酸果糖（FDP）在其治疗中的疗效。方法用ELISA法检测正常新生儿，轻度、中度及重度足月HIE患儿常规治疗组和1,6-二磷酸果糖干预治疗组生后第1、3、7d血清中S100B蛋白、NSE浓度，同时记录生后第3、7、14d新生儿行为评分（NBNA），进行比较；并行S100B蛋白与NSE相关分析。结果①常规治疗组轻度HIE组两值较对照组差异无统计学意义(P>0.05)；中度和重度HIE组S-100B、NSE值较对照组差异有显著意义(P<0.05)，且轻、中、重度组间皆有显著差异(P<0.05)。轻度 HIE患儿 S-100B、NSE呈下降趋势，但差异无统计学意义(P>0.05)，且第7d时与对照组比较没有明显差异；而中度及重度组两者浓度前3d先增高后才下降，与对照组比均有明显差异(P<0.05)，不同时间点之间两两比较差异无统计学意义( P＞0.05)。中度及重度FDP实验干预组第3d起与常规治疗组组间NBNA评分和NSE、S-100B值皆有明显差异(P<0.05)，轻度患儿两组间则差异不明显( P＞0.05)。②血清中NSE、S-100B蛋白两值相关系数为γ=0.841(P<0.001)。结论新生儿缺氧缺血性脑病（HIE）患儿血清中S100B蛋白、NSE水平能较好反映脑损伤程度；早期应用FDP能较迅速有效地改善中、重度HIE患儿脑损伤。
목적：관찰신생인결양결혈성뇌병（HIE）환인혈청중S100B단백、신경원희순화매（NSE）수평변화반영뇌손상병정정도적림상의의화1,6-이린산과당（FDP）재기치료중적료효。방법용ELISA법검측정상신생인，경도、중도급중도족월HIE환인상규치료조화1,6-이린산과당간예치료조생후제1、3、7d혈청중S100B단백、NSE농도，동시기록생후제3、7、14d신생인행위평분（NBNA），진행비교；병행S100B단백여NSE상관분석。결과①상규치료조경도HIE조량치교대조조차이무통계학의의(P>0.05)；중도화중도HIE조S-100B、NSE치교대조조차이유현저의의(P<0.05)，차경、중、중도조간개유현저차이(P<0.05)。경도 HIE환인 S-100B、NSE정하강추세，단차이무통계학의의(P>0.05)，차제7d시여대조조비교몰유명현차이；이중도급중도조량자농도전3d선증고후재하강，여대조조비균유명현차이(P<0.05)，불동시간점지간량량비교차이무통계학의의( P＞0.05)。중도급중도FDP실험간예조제3d기여상규치료조조간NBNA평분화NSE、S-100B치개유명현차이(P<0.05)，경도환인량조간칙차이불명현( P＞0.05)。②혈청중NSE、S-100B단백량치상관계수위γ=0.841(P<0.001)。결론신생인결양결혈성뇌병（HIE）환인혈청중S100B단백、NSE수평능교호반영뇌손상정도；조기응용FDP능교신속유효지개선중、중도HIE환인뇌손상。
Objective to observe changes and clinical significance reflecting brain injury of S100B、neuron enolization enzyme (NSE) in serum of neonates with lhypoxic ischemic encephalopathy (HIE), and curative ef ect of 1, 6 diphosphate fructose (FDP) in its treatment. Methods using ELISA method,to detect serum concentrations of S100B、NSE in normal neonates, neonates with mild, moderate and severe HIE of conventional treatment group or FDP intervention treatment group at 1, 3 and 7 days after born cal ed S100B protein and NSE, meanwhile record neonatal behavior score (NBNA) of them and compare with it.Others to conduct correlation analysis of S100B and NSE. Results①As to S100B and NSE,there was no statistical y significant dif erence between control group (conventional treatment group)and mild HIE group (P>0.05) and significant dif erence among mild, moderate and severe groups (P<0.05),while in moderate group than in severe HIE with significant dif erence (P<0.05), S-100 B, NSE was declining, but there was no statistical y significant dif erence (P>0.05)In mild group , and no significant dif erence with control group compared after the 7th day; In both moderate and severe groups, concentrations of S - 100 B, NSE increased fol owing drop after the 3rd days , obvious dif erent from control group (P<0.05), and no statistical significance between dif erent time points (P> 0.05). In both moderate and severe groups,there was obvious dif erence between the experimental group by FDP injection and routine treatment group after 3 days for NBNA and NSE, S - 100B (P< 0.05), while no statistical significance between mild group and routine treatment group. with the dif erence is not obvious (P>0.05).②Correlation coef icients of NSE, S-100B protein in serum was γ=0.841 (P<0.001). (P<0.001). Conclusion The levels of S100B and NSE in serum of neonates with HIE couid reflect degree of brain injury accurately and objectively ; And early application of FDP could ef ectively and rapidly reverse brain injury of neonates with moderate and severe HIE .