不同程度窒息新生儿血清神经元特异性烯醇化酶和中枢神经特异性蛋白B的表达及意义

赵冰; 丁周志; 陈信

doi:10.16766/j.cnki.issn.1674-4152.001922

不同程度窒息新生儿血清神经元特异性烯醇化酶和中枢神经特异性蛋白B的表达及意义

doi: 10.16766/j.cnki.issn.1674-4152.001922

蚌埠医学院第一附属医院儿科，安徽蚌埠 233004

基金项目:

安徽省高校自然科学研究重点项目 KJ2019A0378

详细信息

通讯作者:
丁周志，E-mail：719295719@qq.com

中图分类号: R722.12 R446
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- 被引次数: 0
出版历程
- 收稿日期: 2020-06-08
- 网络出版日期: 2022-02-16

Expression and significance of serum NSE and S100B protein during different degrees of neonatal asphyxia

Neonatal Intensive Care Unit, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的新生儿窒息为新生儿时期的常见病，早期正确诊断对于治疗至关重要，本文主要研究神经元特异性烯醇化酶(neuron specific enolase, NSE)和中枢神经特异性蛋白B(S100B protein)在不同程度窒息新生儿血清中的表达，并探讨其对新生儿窒息的诊断价值。方法选取2018年12月—2020年4月因出生窒息入住蚌埠医学院第一附属医院NICU的新生儿70例为窒息组，根据出生时Apgar评分分为2组：轻度窒息组(40例)和重度窒息组(30例)。正常对照组选取同期健康新生儿40例。检测各组新生儿生后24 h内及窒息组新生儿治疗7 d后的血清NSE、S100B水平。结果轻度窒息组和重度窒息组血清NSE、S100B水平较对照组明显升高(均P < 0.05)；重度窒息组血清NSE、S100B水平较轻度窒息组明显升高(均P < 0.05)。治疗后，轻度窒息组和重度窒息组血清NSE、S100B水平均明显降低(均P < 0.05)。血清NSE对新生儿窒息预测的灵敏度为81.43%，特异度为97.50%，AUC为0.939。血清S100B对新生儿窒息预测的灵敏度为80.00%，特异度为100.00%，AUC为0.916。结论血清NSE和S100B可作为诊断新生儿窒息的重要依据，对临床上评估新生儿窒息程度具有一定参考价值。
- 新生儿窒息 /
- 神经元特异性烯醇化酶 /
- 中枢神经特异性蛋白B /
- Apgar评分
Abstract: Objective Neonatal asphyxia is a common disease during the neonatal period. Early and correct diagnosis of this disease is very important for treatment. This study investigated the expression of neuron-specific enolase (NSE) and central nervous system-specific protein B (S100B protein) in the serum of newborns with different degrees of asphyxia. This study examined whether these proteins can be used as indicators in the diagnosis of neonatal asphyxia. Methods Seventy newborns admitted to the NICU of the First Affiliated Hospital of Bengbu Medical College from December 2018 to April 2020 were selected and assigned to the asphyxia group. Then according to the Apgar(appearance, pulse, grimace, activity, and respiration) score at birth, the they were again divided into mild asphyxia group (n=40) and severe asphyxia group (n=30). 40 healthy newborns were selected as the normal control group, during the same period. The Levels of serum NSE and S100B were measured within 24 h after birth in each group and 7 days after treatment in the asphyxia group. Results The levels of serum NSE and S100B in the mild asphyxia and severe asphyxia groups were significantly higher than those in the control group. The levels of serum NSE and S100B in the severe asphyxia group were significantly higher than those in the mild asphyxia group (all P < 0.05). After the treatment, the levels of serum NSE and S100B in the mild asphyxia and severe asphyxia groups significantly decreased (all P < 0.05). The sensitivity and specificity of serum NSE to the prediction of neonatal asphyxia were 81.43% and 97.50%, respectively. The area under the receiver operating characteristic curve (AUC) was 0.939. By comparison, the sensitivity and specificity of serum S100B to the prediction of neonatal asphyxia were 80.00% and 100.00%, respectively. The AUC curve was 0.916. Conclusion Both serum NSE and S100B can be used as an important basis for the diagnosis of neonatal asphyxia and have a certain reference value for clinical evaluation of the degree of neonatal asphyxia.
- Neonatal asphyxia /
- Neuron-specific enolase /
- S100B /
- Apgascore

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图 1 ROC曲线分析血清NSE和S100B预测新生儿窒息的价值

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表 1 新生儿窒息危险因素的单因素分析结果[M(P₂₅, P₇₅)]

组别	例数	性别(男/女, 例)	分娩方式(顺产/剖宫产, 例)	胎龄(周)	出生体重(kg)	NSE(ng/mL)	S100B(ng/L)
对照组	40	21/19	24/16	39.0(38.0, 40.0)	3.27(3.01, 3.60)	12.84(10.23, 16.09)	315.50(254.00, 381.25)
窒息组	70	34/36	31/39	39.2(38.4, 40.0)	3.20(2.90, 3.61)	35.65(22.56, 56.20)	861.00(471.00, 1 393.00)
统计量		0.157^a	2.514^a	-1.537^b	-0.768^b	-7.640^b	-7.239^b
P值		0.692	0.113	0.124	0.443	< 0.001	< 0.001
注：^a为χ²值，^b为Z值。

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表 2 新生儿窒息危险因素的多因素分析结果

项目	B	SE	Wald χ²	P值	OR值	95% CI
NSE	0.275	0.088	9.703	0.002	1.317	1.107~1.566
S100B	0.015	0.006	5.986	0.014	1.015	1.003~1.028

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表 3 各组新生儿血清NSE、S100B水平比较[M(P₂₅, P₇₅)]

组别	例数	NSE(ng/mL)	S100B(ng/L)
对照组	40	12.84(10.23, 16.09)	315.50(254.00, 381.25)
轻度窒息组	40	31.71(21.12, 40.27)^a	812.50(422.75, 1 077.50)^a
重度窒息组	30	41.06(28.50, 55.58)^ab	1 335.00(510.50, 2 630.00)^ab
H值		60.008	55.162
P值		< 0.001	< 0.001
注：与对照组比较，^aP < 0.05；与轻度窒息组比较，^bP < 0.05。

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表 4 2组窒息新生儿治疗前后血清NSE、S100B水平比较[M(P₂₅, P₇₅)]

组别	例数	NSE(ng/mL)		Z值	P值	S100B(ng/L)		Z值	P值
组别	例数	治疗前	治疗后	Z值	P值	治疗前	治疗后	Z值	P值
轻度窒息组	40	31.71(21.12, 40.27)	12.88(10.30, 15.20)	-5.471	< 0.001	812.50(422.75, 1 077.50)	306.00(253.25, 338.50)	-5.317	< 0.001
重度窒息组	30	41.06(28.50, 55.58)	15.97(13.80, 18.40)	-4.597	< 0.001	1 335.00(510.50, 2 630.00)	360.00(294.00, 429.75)	-4.350	< 0.001

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