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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

35

期数:

2018年6

页码:

540-544

栏目:

临床研究

出版日期:

2018-06-05

文章信息/Info

Title:

Diagnostic value of cranial ultrasonic examination combined with the detection of serum neuron specific enolase，S100B and interleukin-6 on cerebral white matter lesions of premature infant

作者:

李宏伟¹; 王洁翡²; 艾　亮³; 张　静⁴

（1.郑州市妇幼保健院超声科，河南　郑州　450012；2.郑州市妇幼保健院新生儿科，河南　郑州　450012；3.郑州市妇幼保健院检验科，河南　郑州　450012；4.郑州市妇幼保健院女性康复科，河南　郑州　450012）

Author(s):

LI Hong-wei¹; WANG Jie-fei²; AI Liang³; ZHANG Jing⁴

（1.Department of Ultrasound，Women and Infants Hospital of Zhengzhou City，Zhengzhou 450012，Henan Province，China；2.Department of Neonatology，Women and Infants Hospital of Zhengzhou City，Zhengzhou 450012，Henan Province，China；3.Department of Clinical Laboratory，Women and Infants Hospital of Zhengzhou City，Zhengzhou 450012，Henan Province，China；4.Department of Female Rehabilitation，Women and Infants Hospital of Zhengzhou City，Zhengzhou 450012，Henan Province，China）

关键词:

脑白质受损; 颅脑超声; 神经元特异性烯醇化酶; 白细胞介素-6; S100钙结合蛋白B

Keywords:

cerebral white matter lesions; cranial ultrasonic examination; neuron-specific enolase; interleukin-6; S100 calcium binding protein B

分类号:

R722.6

DOI:

10.7683/xxyxyxb.2018.06.024

文献标志码:

A

摘要:

目的　探讨颅脑超声联合血清神经元特异性烯醇化酶（NSE）、S100B及白细胞介素-6（IL-6）检测对早产儿脑白质损伤的诊断价值。方法　选择2016年8月至2017年7月郑州市妇幼保健院新生儿科收治的经颅脑磁共振成像（MRI）检查诊断为脑白质损伤的早产儿39例为观察组，另选同期经颅脑MRI检查诊断脑白质无损伤的早产儿30例为对照组，分别于出生后1、3、7 d采用全自动时间分辨荧光免疫分析系统检测血清NSE水平，双抗体夹心酶联免疫吸附试验测定血清S100B、IL-6水平，并采用颅脑超声观测脑室周围脑白质回声的变化，分析颅脑超声与NSE、S100B、IL-6联合对诊断早产儿脑白质损伤的灵敏度、特异度和准确性。结果　在出生后1、3、7 d，对照组患儿颅脑超声检查脑白质损伤检出率分别为6.45%（2/31）、3.23%（1/31）和0.00%（0/31），观察组患儿脑白质损伤检出率分别为92.31%（36/39）、87.18%（34/39）和84.62%（33/39）；观察组患儿出生后1、3、7 d脑白质损伤的检出率均显著高于对照组（χ²=51.30、48.69、49.63，P<0.05）。对照组、观察组患儿出生后1、3、7 d脑白质的超声灰度值组内比较差异均无统计学意义（P>0.05），但观察组患儿脑白质的灰度值与对照组比较均显著增高（P<0.05）。对照组患儿出生后1、3、7 d血清S100B、IL-6水平比较差异无统计学意义（F=0.319、0.307，P>0.05），血清NSE水平比较差异有统计学意义（F= 3.298，P<0.05），其中出生后3、7 d血清NSE水平显著低于出生后 1 d（P<0.05），出生后7 d血清NSE水平显著低于出生后3 d（P<0.05）。观察组患儿出生后1、3、7 d血清NSE、S100B、IL-6水平均呈现下降趋势（F=3.323、3.517、3.706，P<0.05），其中出生后3、7 d，观察组患儿血清NSE、S100B、IL-6水平与出生后1 d比较显著下降（P<0.05），出生后7 d 观察组患儿血清NSE、S100B、IL-6水平与出生后3 d比较差异无统计学意义（P>0.05）；与对照组比较，观察组患儿出生后1、3、7 d血清NSE、S100B、IL-6水平均显著增高（P<0.05）。观察组患儿出生后1 d颅脑超声脑白质灰度值与血清NSE、S100B和IL-6水平均呈显著正相关（r=3.137、3.358、3.056，P<0.05）；出生后 3 d 脑白质灰度值与血清S100B、NSE水平呈显著正相关（r=2.872、2.347，P<0.05），出生后7 d脑白质灰度值与S100B呈显著正相关（r=2.791，P<0.05）。颅脑超声+NSE+S100B联合检测诊断脑白质损伤具有较高的灵敏度（100.00%）、特异度（93.54%）和准确性（97.14%）。结论　颅脑超声、NSE、S100B联合检测可显著提高早期诊断脑白质损伤的准确性。

Abstract:

Objective　To investigate the diagnostic value of cranial ultrasonic examination combined with the detection of serum neuron specific enolase（NSE），S100B and interleukin-6（IL-6） on cerebral white matter lesions of premature infant.Methods　Thirty-nine premature infants with cerebral white matter injury diagnosed by cranial magnetic resonance imaging（MRI） in Women and Infants Hospital of Zhengzhou City from August 2016 to July 2017 were selected as observation group.Another thirty premature infants without brain white matter injury were selected as control group in the same period.On the 1^st，3^rd and 7^th day after birth，the serum NSE level was detected by the automatic time resolved fluoroimmunoassay system，the levels of serum S100B and IL-6 were detected by double anti sandwich enzyme-linked immunosorbent assay，and the changes of the cerebral white matter echoes around the cerebral ventricles were observed by cranial ultrasonic examination.The sensitivity，specificity and accuracy combined detection of cranial ultrasonic examination combined with serum NSE，S100B and IL-6 in the diagnosis of white matter lesions in premature infants were analyzed.Results　The detection rate of cerebral white matter lesions by cranial ultrasonic examination in the control group was 6.45%（2/31），3.23%（1/31） and 0.00%（0/31） respectively；and it was 92.31%（36/39），87.18%（34/39） and 84.62%（33/39） respectively on the 1^st，3^rd and 7^th day after birth in the observation group；the detection rate of cerebral white matter lesions in the observation group was significantly higher than that in the control group on the 1^st，3^rd and 7^th day after birth（χ²=51.30，48.69，49.63；P<0.05）.There was no significant difference in the grayscale value of cerebral white matter among the 1^st，3^rd and 7^th day after birth in the two groups（P>0.05）.The grayscale value of cerebral white matter in the observation group was significantly higher than that in the control group on the 1^st，3^rd and 7^th day after birth（P<0.05）.There was no significant difference in serum S100B and IL-6 levels among the 1^st，3^rd and 7^th day after birth in the control group（F=0.319，0.307；P>0.05）.There was the significant difference in serum NSE level among the 1^st，3^rd and 7^th day after birth in the control group（F=3.298，P<0.05），the serum NSE level on the 3^rd and 7^th day after birth was significantly lower than that on the 1st day after birth（P<0.05），the serum NSE level on the 7^th day after birth was significantly lower than that on the 3^rd day after birth（P<0.05）.The levels of serum NSE，S100B and IL-6 in the observation group showed the downward trend on the 1^st，3^rd and 7^th day after birth（F=3.323，3.517，3.706；P<0.05）.The levels of serum NSE，S100B and IL-6 on the 3^rd and 7^th day after birth were significantly lower than those on the 1^st day after birth in the observation group（P<0.05）.There was no significant difference in the levels of serum NSE，S100B and IL-6 between the 3^rd and 7^th day after birth in the observation group（P<0.05）.The levels of serum NSE，S100B and IL-6 in the observation group were significantly higher than those in the control group on the 1^st，3^rd and 7^th day after birth（P<0.05）.In the observation group，the grayscale value of cerebral white matter was positively correlated with the levels of serum NSE，S100B and IL-6 on the 1^st day after birth（r=3.137，3.358，3.056；P<0.05）；the grayscale value of cerebral white matter was positively correlated with the levels of serum NSE and S100B on the 3^rd day after birth（r=2.872，2.347；P<0.05）；the grayscale value of cerebral white matter was positively correlated with serum S100B level on the 7^th day after birth（r=2.791，P<0.05）.The sensitivity，specificity and accuracy of combined detection of cranial ultrasonic examination and，serum NSE and S100B in the diagnosis of cerebral white matter lesions in premature infants was 100.00%，93.54% and 97.14% respectively.Conclusion　The combined detection of cranial ultrasonic examination，serum NSE and S100B can significantly improve the accuracy of early diagnosis of cerebral white matter lesions.

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更新日期/Last Update: 2018-06-05