脑瘫患儿血清神经元特异性烯醇化酶及髓鞘碱性蛋白浓度的变化及其临床意义

摘要
图/表
参考文献
相关文章 (3)

全文: PDF (985 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的: 探讨脑瘫患儿血清神经元特异性烯醇化酶(neuronspecific enolase，NSE)和髓鞘碱性蛋白（myelin basic protein，MBP）水平的变化及其临床意义。方法: 选取进行康复治疗的符合脑瘫诊断标准的脑瘫患儿46例（脑瘫组），同时选取性别、年龄与脑瘫组患儿匹配的健康儿童45名作为健康对照组。采用酶联免疫吸附试验(ELISA)法检测健康组儿童体检时及脑瘫组患儿治疗前、常规康复治疗3个月后的血清NSE和MBP浓度。采用脑瘫粗大运动功能分级系统（GMFCS）和粗大运动功能88项量表（GMFM88）对脑瘫组患儿治疗前、后的粗大运动功能进行分级和评估。结果：健康组儿童血清NSE、MBP浓度分别为（6.77±2.08）μg/L、（0.38±0.10）μg/L；脑瘫组患儿治疗前血清NSE、MBP浓度分别为（16.26±2.94）μg/L、（1.21±0.41）μg/L，治疗3个月后浓度分别为（13.56±2.29）μg/L、（0.85±0.33）μg/L；脑瘫组患儿治疗前、后的GMFM88评分分别为（132.33±81.60）分、（147.07±83.13）分。健康组儿童的NSE、MBP浓度与年龄之间均无显著相关性（P＞0.05），而脑瘫组患儿治疗前的NSE、MBP浓度与年龄之间均呈负相关(P＜0.05)。脑瘫组儿童治疗前的NSE、MBP浓度均明显高于健康组(均P＜0.05)。脑瘫组治疗前的NSE、MBP浓度与脑瘫粗大运动功能分级（GMFCS）之间均呈正相关(P＜0.05)，与GMFM88评分之间均呈负相关(P＜0.05)。脑瘫组治疗前、后组内NSE、MBP浓度、GMFM88评分间的差异均具有统计学意义(P＜0.05)。结论：脑瘫患儿血清NSE和MBP浓度较健康儿童显著升高，随年龄增加而降低，且与脑瘫的障碍程度及粗大运动功能相关。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：脑瘫, 神经元特异性烯醇化酶, 髓鞘碱性蛋白

Abstract：Objective: To investigate the changes and clinical significance of serum neuronspecific enolase(NSE) and myelin basic protein(MBP) in children with cerebral palsy. Methods: A total of 46 cases of children with cerebral palsy were selected as observation group，in the same period, 45 cases of sex and age matched healthy children were selected as control group. The serum levels of NSE and MBP in the control group at the time of physical examination and in the observation group before and after 3 months of routine rehabilitation were detected by enzyme linked immunosorbent assay(ELISA). The cerebral palsy Gross Motor Function Classification System(GMFCS) and the Gross Motor Function Measure 88 item(GMFM88) were used to grade and evaluate the gross motor function before and after treatment in the observation group. Results: The serum levels of NSE and MBP in the control group were (6.77±2.08) μg/L and (0.38±0.10) μg/L; the serum levels of NSE and MBP in the observation group before treatment were (16.26±2.94) μg/L and (1.21±0.41) μg/L respectively, and the serum levels of NSE and MBP in the observation group after 3 months of treatment were (13.56±2.29)μg/L and (0.85±0.33)μg/L respectively; the GMFM88 scores of the observation group before and after treatment were (132.33±81.60) and (147.07±83.13) respectively. There was no significant correlation between NSE or MBP levels and age in healthy children of the control group (P>0.05)，and there was a negative correlation between NSE or MBP levels and age before treatment in the observation group (P<0.05). There were significant differences in the levels of NSE or MBP between the control group and the observation group(P<0.05). There was a positive correlation between NSE or MBP levels of the observation group and GMFCS in children with cerebral palsy, and a negative correlation with GMFM88 score (P<0.05). The differences of NSE, MBP and GMFM88 scores in the observation group before and after treatment were statistically significant (P<0.05). Conclusion: Serum NSE and MBP levels in children with cerebral palsy were significantly higher than those in healthy children, and decreased with increasing of age, and correlated with the degree of cerebral palsy and gross motor function.

收稿日期: 2018-10-31

基金资助:淮安市科技计划项目（HASZ201619）

通讯作者: 钱晖（通讯作者），教授，博士生导师，E-mail: lstmmmlst@163.com

作者简介: 刘冬梅（1982—），女，江苏涟水人，主管技师，主要从事医学临床检验研究；

引用本文:

刘冬梅1，2，钱晖1，吕艳关2，赵玉杰2，魏红2. 脑瘫患儿血清神经元特异性烯醇化酶及髓鞘碱性蛋白浓度的变化及其临床意义[J]. 江苏大学学报:医学版, 2019, 29(01): 49-53. LIU Dong-mei1，2, QIAN Hui1, L Yan-guan2, ZHAO Yu-jie2, WEI Hong2. The detection and clinical significance of serum neuronspecific enolase and myelin basic protein in children with cerebral palsy . Journal of Jiangsu University(Medicine Edition), 2019, 29(01): 49-53.

链接本文:

http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2019/V29/I01/49

［1］Numata Y,Onuma A,Kobayashi Y,et al.Brain magnetic resonance imaging and motor and intellectual functioning in 86 patients born at term with spastic diplegia\[J\]. Dev Med Child Neurol, 2013,55(2): 167-172.

［2］Panigrahy A,Wisnowski JL,Furtado A,et al.Neuroimaging biomarkers of preterm brain injury: toward developing the preterm connectome\[J\]. Pediatr Radiol,2012,42(Suppl 1):S33-61.

［3］于雪峰,樊祥伟,高晶,等.电针刺激头部运动区协同UCMSC移植对脑瘫鼠脑组织神经生长相关蛋白的影响\[J\].中华中医药杂志,2015,30(11):4112-4114.

［4］栗艳芳. 头皮位点药物注射对宫内感染早产鼠的脑保护作用\[D\].郑州：郑州大学,2012.

［5］冉敏.血清NSE水平与脑瘫患儿智能发育的相关性研究\[J\].皖南医学院学报,2017,36(1):80-82.

［6］尤玉慧,崔志慧,尹水贵,等.0～6个月龄脑瘫高危儿血清NSE表达特点及临床价值\[J\].医学研究杂志,2013,42(6):98-101.

［7］中国康复医学会儿童康复专业委员会,中国残疾人康复协会小儿脑瘫康复专业委员会.小儿脑性瘫痪的定义、分型和诊断条件\[J\].中华物理医学与康复杂志,2007,29(5):309-310.

［8］Wu J,Li X.Plasma tumor necrosis factoralpha (TNFα) levels correlate with disease severity in spastic diplegia,triplegia, and quadriplegia in children with cerebral palsy\[J\].Med Sci Monit,2015, 21:3868-3874.

［9］高晶,王丽娜,赵斌.虚拟情景循环踏车训练对痉挛型脑瘫患儿下肢肌张力及运动功能的影响\[J\].中华物理医学与康复杂志,2015,37(6):432-435.

［10］刘振寰.脑性瘫痪儿童的中西医结合康复探讨\[J\].中国儿童保健杂志,2011,19(5):395-397.

［11］Blinov DV,Terent′ev AA.Protein markers of hypoxicischemic lesions of the CNS in the perinatal period\[J\]. Neurochem J, 2013, 7(1):16-22.

［12］李玉艳,梁琳琳,刘晓勇.颅脑损伤患者脑脊液和血清神经元特异性烯醇化酶及髓鞘碱性蛋白水平变化及临床意义\[J\]. 国际检验医学杂志, 2017, 38(10):1338-1340.

［13］Stefanovic＇ B,D-uric＇ O, Stankovic＇ S, et al. Elevated serum protein s100b and neuron specific enolase values as predictors of early neurological outcome after traumatic brain injury\[J\]. J Med Biochem,2017, 36 (4):314-321.

［14］Pinelis VG, Sorokina EG, Semenova JB, et al. Biomarkers in children with traumatic brain injury\[J\]. Zh Nevrol Psikhiatr Im S S Korsakova,2015,115(8):66-72.

［15］Risso FM, Sannia A,Gavilanes DA,et al. Biomarkers of brain damage in preterm infants\[J\]. J Matern Fetal Neonatal Med, 2012,25(Suppl 4):S101-104.

［16］陈珊,李薇,瞿柳红,等.血浆S100B蛋白和髓鞘碱性蛋白与早产儿脑损伤的关系\[J\]. 中华实用儿科临床杂志, 2014, 29(12):902-906.