中国实用神经疾病杂志2016，Vol.19Issue(5)：2-5,4.
NSE对新生儿高胆红素血症换血治疗的指导意义
The guiding effect of serum NSE levels on exchange transfusion treatment of neonatal hyperbilirubinemia
摘要
Abstract
Objective To study the effect of the early detections of serum neuron-specific enolase (NSE) levels and brain MRI of neonatal hyperbilirubinemia in order to find neonatal bilirubin brain injury and guide the positive exchange transfusion therapy in time.Methods We detected serum NSE levels and brain MRI of 60 cases with severe neonatal hyperbilirubinemia and 25 cases with neonatal bilirubin encephalopathy in our hospital from December 2010 to December 2013.Then NSE values and the change of brain MRI at different levels of bilirubin were analyzed.Neonates with bilirubin encephalopathy and hyperbilirubinemia accompanied by MRI brain damage (signal change of globus pallidus) were performed by exchange transfusion therapy at 24 hours,and the remaining neonates without brain damage were treated by phototherapy.Finally we reexamined serum NSE levels and MRI.Results Serum NSE levels of both severe neonatal hyperbilirubinemia and neonatal bilirubin encephalopathy increased obviously,and neonatal bilirubin encephalopathy had higher levels (P＜0.05).We found that four cases among 60 severe hyperlipidemia neonates and 14 cases among 25 bilirubin encephalopathy neonates were complicated with MRI change of bilirubin brain damage,whose NSE levels were declined by more than 50％ at 24 hours after exchange transfusion therapy,and the MRI recovered at one-month visit in 4 cases.Serum NSE levels at 24 hours after phototherapy treatment decreased by 30％ with significant difference compared with exchange transfusion therapy.Conclusions Serum NSE levels with MRI examination can early reflect brain damage,and serum NSE values of brain damage neonates have significant different relative to neonates without brain damage.Exchange transfusion therapy may take advantage over phototherapy in terms of declining NSE levels.Thus,neonatal hyperbilirubinemia can receive exchange transfusion therapy based on NSE values to prevent the occurrence of complications.关键词
高胆红素血症/神经元特异性烯醇化酶/换血Key words
Hyperbilirubinemia/Neuron-specific enolase/Exchange transfusion分类
医药卫生引用本文复制引用
陈兴月..NSE对新生儿高胆红素血症换血治疗的指导意义[J].中国实用神经疾病杂志,2016,19(5):2-5,4.基金项目
海南省卫生厅资助课题,项目编号13A210283 （）
