血清S100B蛋白在新生儿窒息后脑损伤中的临床意义

Clinical significance of serum S100B protein in brain damage following neonatal-asphyxia

摘要:

目的：S100B蛋白是一种脑特异性蛋白,可反映脑损伤的程度。该研究旨在探讨窒息新生儿脐血及生后血清S100B蛋白的变化及对新生儿窒息诊断和窒息后脑损伤判断的价值。方法：对窒息新生儿的脐血及生后1,3,7d血清S100B蛋白变化进行分析。结果：①窒息新生儿脐血S100B蛋白水平高于正常对照组,差异有显著性(P<0.05),轻度窒息与重度窒息患儿脐血S100B蛋白含量差异无显著性;②出生后1～7d内轻度窒息患儿血清S100B蛋白无明显变化,重度窒息脑损伤患儿血清S100B蛋白呈逐渐增高趋势,生后第7天时重度窒息脑损伤患儿血清S100B蛋白明显高于轻度窒息患儿(P<0.01);③死亡的窒息患儿生后第7天的血清S100B蛋白含量高于存活儿,但差异无显著性(P>0.05);④发生颅内出血和/或脑水肿的患儿生后第3天血清S100B蛋白含量增高,差异有显著性(P<0.05)。结论：血清S100B蛋白检测有助于新生儿窒息的诊断及窒息后脑损伤的判断。

Abstract:

OBJECTIVE: S100B protein, a special brain protein, is associated with the degree and prognosis of brain damage. This study determined the levels of S100B protein in cord blood and serum of neonates with asphyxia. The aim was to investigate the values of S100B protein in the diagnosis of neonatal asphyxia and in the identification of brain damage following neonatal asphyxia. METHODS: Thirty-two newborn infants with asphyxia (Asphyxia group) and 36 normal newborn infants (Control group ) were enrolled in this study. The cord blood and serum S100B protein was measured by ELISA on days 1, 3, and 7 after birth. RESULTS: Mean cord blood S100B protein levels in the Asphyxia group were significantly higher than those in the Control group ( P< 0.05 ). After birth, the serum S100B protein of infants with severe asphyxia complicated by brain damage increased progressively and was significantly higher than those infants with mild asphyxia on day 7 (P<0.01 ). On day 7 serum S100B protein content in infants who died was higher than in infants who survived, but there was no statistical differences . On day 3 asphyxiated infants with intracranial hemorrhage and/or hydrocephalus showed a higher level of serum S100B protein than those without brain damage (P<0.05). CONCLUSIONS: Serum S100B protein is a useful index for the diagnosis of neonatal asphyxia and the identification of brain damage following neonatal asphyxia.