Correlation Between Serum NSE Level And The Prognosis Of Neonatal Hypoxic Ischemic Encephalopathy

Neonatal hypoxic-ischemic encephalopathy(HIE) refers to the hypoxic andischemic brain injury after perinatal asphyxia, which is one of the important reasons inneonatal acute death and chronic sequelae in our country．It has great significance togive early detection，diagnosis and intervention in degrading the mortality and disabilityrate of the pefinatal stage and improve the population quality．However, because thediagnosis and division is mainly depends on clinical symptoms，the changes afterhypoxic-ischemic of the biochemical marker have caused the extensive concern inscholars at home and abroad. Neuron specific enolase (NSE) is one of the idealbiochemical markers that indicate brain injury. Studies show that when hypoxic andischemic brain injury occurred, NSE is increasing obviously, and it is positively relatedwith brain injury. It provides an effective way for HIE diagnosis to detect the existenceof these molecules．Purpose：This study inquire into the new method for early diagnosis of the in fullterm HIE neonate of the motor nerve growth delay and provide the theory evidence forearly treat and forecast by observe the different value of serum NSE level in thedifferent clinical full term HIE neonate born after24hours, and the relation between theNBNA (Neonatal Behaviral Neurological Assessment) score of the20kinds of action ofclinical full term HIE neonate born after7days.Methods：Resptospective studies60HIE neonates in our court in the past twoyears (2010-2012)．The inclusion criteria for the HIE neonates is: gestational agebetween37week and42week;birth weight between2.5kg and4kg;expelled brain injurecasing pathoglycemia, electrolyte disturbance, hyperbilirubinemia and infectiousdiseases; expelled brain malformations and intracranial hemorrhage etc. The HIEneonates are diagnosed and graduated by the latest diagnose criteria, and have beentreated after7days or above. According to the clinical graduation, they are distinguished to two groups, one is minor HIE neonates group, and the other ismoderate and severe HIE neonates group. And the studies also choose the normal fullterm neonates in the same time as the compare. The studies observe and analyze thedifference of serum NSE level between different group of the neonates and thedifference of NBNA score and the relation of the above two. The studies also use theSPSS17.0software to do statistics and analysis by “t examine” and “variance analysis”,and the result has the significance on statistics if P<0.05.Results：1.By compare the serum NSE level in the full term neonates born after24hours, the study find that the serum NSE levels are26.71±5.33μg∕l,51.86±8.96μg∕l and8.82±2.96μg∕l corresponding to minor HIE group, moderate or serve HIEgroup and the normal neonates group. The normal group’s level <minor group’s level <moderate or serve group’s level, and the difference between both two group are all havethe statistics significance.2.By compare the NBNA score in each group of full term neonates born after7days, the study find that the NBNA score are38.63±0.89,36.27±1.82and39.17±1.70corresponding to minor HIE group, moderate or serve HIE group and the normalneonates group. The normal group’s score <minor group’s score <moderate or servegroup’s score, and the difference between both two group are all have the statisticssignificance.3.The study also find the relation between the serum NSE level born after24hoursand the NBNA score born after7days of the full term HIE neonates. If the average NSElevel is higher of the full term HIE neonates born after24hours, the NBNA score willbe lower of them. The study conclude that if the NSE level is more than55.43μg∕lborn after24hours, the NBNA score should less than35born after7days of the fullterm HIE neonates. And it means that this neonate may have undesirable motor nervedisease, and the doctor should give him/her the hospital treat and recover intervene asearly as possible.Conclusion：Serum NSE level is a sensitive index of HIE and its neurologicalinjury, and it is concordance with the clinical manifestation degrees. There arecorrelations between the two indexes. We can perform early diagnosis and evaluation ofHIE by determine the Serum NSE level of neonates born after24hours.