促红细胞生成素对新生儿缺氧缺血性脑病患儿血清NSE和S-100B的影响

Effects of erythropoietin on serum NSE and S-100B levels in neonates with hypoxicischemic encephalopathy

摘要:

目的 探讨促红细胞生成素（EPO）对缺氧缺血性脑病（HIE）患儿血清NSE、S-100B 水平的影响及其作用机制。方法 40 例HIE 患儿随机分为常规治疗组（20 例）和EPO 治疗组（20 例），EPO 治疗组在常规治疗基础上于生后第2 天加用EPO，每日200 IU/kg 静脉注入，疗程7 d。另选择健康足月新生儿20 例作为正常对照组。检测3 组新生儿血清中NSE、S-100B 的水平。结果 治疗前2 组HIE 患儿血清中NSE、S-100B的水平高于正常新生儿（P<0.01），而2 组HIE 患儿之间血清中NSE、S-100B 的水平差异无统计学意义（P>0.05）。3 组新生儿生后第9 天血清NSE、S-100B 水平均低于第1 天水平（P<0.01）。治疗后EPO 治疗组血清NSE、S-100B水平低于常规治疗组（P<0.05）。结论 动态检测血清中NSE、S-100B 的水平，可能有助于HIE 的早期诊断和判断HIE 脑损伤的修复程度；EPO 可能对神经元及神经胶质细胞均有修复作用。

Abstract:

Objective To study the effects of erythropoietin (EPO) on serum levels of neuron-specific enolase (NSE) and S-100B in neonates with hypoxic-ischemic encephalopathy (HIE) and the underlying mechanism. Methods Forty neonates with HIE were randomly divided into conventional treatment (n=20) and EPO treatment groups (n=20). Twenty healthy full-term neonates born during the same period were randomly selected as the normal control group. The conventional treatment group received conventional treatment, while the EPO treatment group received conventional treatment as well as EPO [200 IU/(kg·d)] which was given by intravenous infusion from the second day after birth. The course of treatment was 7 days. Blood samples of the three groups were collected on the first day after birth (before treatment) and the ninth day after birth (after treatment). Serum levels of NSE and S-100B were measured by doubleantibody sandwich ABC-ELISA. Results Before treatment, the two treatment groups had significantly higher serum NSE and S-100B levels than the normal control group (P<0.01), whereas no significant differences in the levels of NSE and S-100B were observed between the conventional treatment and EPO treatment groups (P>0.05). The serum NSE and S-100B levels on the ninth day after birth were significantly lower than those on the first day after birth in the three groups (P<0.01). After treatment, the serum NSE and S-100B levels were significantly lower in the EPO treatment group than in the conventional treatment group (P<0.05). Conclusions Dynamic monitoring of serum NSE and S-100B levels may be helpful for the early diagnosis of HIE and the assessment of brain injury repair in newborns with HIE. EPO may be helpful for the repair of neurons and glial cells.