Correlation Between Serum NSE Level, NBNA Score And Clinical Manifestation In Neonatal Hypoxic Ischemic Encephalopathy

BackgroundNeonatal hypoxic ischemic encephalopathy(HIE) refers to the hypoxic and ischemic brain injury after perinatal asphyxia,which plays an important role in neonatal acute death and chronic sequelae in our country.It is of great significance to give early detection,diagnosis and intervention in degrading the mortality and disability rate of the perinatal stage and elevating the population quality.Because of the necrosis and disaggregation of the neurocyte,some special molecules(such as S-100,NSE,et al) are released by the cytoplasm and organelle.It provides an effective way for HIE diagnosis to detect the existence of these molecules. Neuron-specific enolase(NSE) is an enzyme that specialized located in the neuron cells and the neural endocrine cells.The enzyme can be released from these cells after their death induced by hypoxic ischemic injury.It is a sign of neurocytic injury that the concentration of this enzyme evaluating in cerebrospinal fluid and peripheral circulation, with high sensitivity and certain specificity.Neonatal Behaviral Neurological Assessment(NBNA) is a system of behaviral neurological assessment that develops from foreign behaviral neurological assessments and it is suitable for widely practicing in our country.It is also of great significance to undertake behaviral neurological assessment in evaluating the condition and the prognosis of the neonates.PurposeTo investigate the variance of the serum neuron-specific enolase(NSE) level and the Neonatal Behaviral Neurological Assessment(NBNA) score of the HIE neonates,and the relation between the clinical graduation and the both above,which may provide the evidence for evaluation and early diagnosis of the disease.Methods50 neonates are brought into the research,including 10 normal ones for control group and 40 HIE ones for experimental group,in which term neonates are diagnosed and graduated by domestic unified standards,and preterm ones are diagnosed by their precise hypoxic and ischemic history.All the research objects are obtained blood samples for NSE detecting and proceeded NBNA on proper time,expelled other interference diseases.Statistics analysis is used to determine the differences of NSE levels and NBNA scores between each group.Full term neonates and pre-term ones are compared individually.The concordance between the index above and clinical graduating and the dependablity between the HIE levels and NBNA scores are also determined.ResultsIn full term neonates,as the aggravation of the degree of HIE,the serum NSE levels get increased and NBNA scores get decreased.There are significant differences of NSE levels and NBNA scores between the control group and experimental group(P＜0.05). There are also significant differences of NSE levels and NBNA scores between each degree of the experimental group(P＜0.05).It indicates that in preterm neonates,as the aggravation of the clinical manifestation degree,the serum NSE levels get increased and the NBNA scores get decreased.Compared with the control group,the NSE levels and NBNA scores of the moderate and the severe HIE group have significant differences and there are also significant differences between the two groups(P＜0.05).However,the differences of the two indexes between the mild HIE group and the control group is not significant(P＞0.05).In preterm neonates,serum NSE levels have good dependability with NBNA scores(r=-0.72576):Y=888.66615-22.18736 X(X=NBNA score,Y=NSE level)ConclusionSerum NSE level and NBNA score are sensitive index of HIE and its neurological injury.And they are concordance with the clinical manifestation degrees.There are correlations between the two indexes.We can perform early diagnosis and evaluation of HIE by utilization of the two indexes.