Biomarkers of brain injury in neonatal encephalopathy treated with hypothermia.
Biomarkers of brain injury in neonatal encephalopathy treated with hypothermia.
复制标题
DOI：
10.1016/j.jpeds.2012.02.047
复制
发表时间：
2012-09
影响因子：
5.1
通讯作者：
Nelson, Karin B.
中科院分区：
文献类型：
--
作者：
Massaro, An N.;Chang, Taeun;Kadom, Nadja;Tsuchida, Tammy;Scafidi, Joseph;Glass, Penny;McCarter, Robert;Baumgart, Stephen;Vezina, Gilbert;Nelson, Karin B.
确定早期血清S100B和神经元特异性烯醇化酶（NSE）水平是否与新生儿脑病脑损伤的神经放射学和临床证据相关。接受治疗性全身低温治疗的患者被前瞻性地纳入这项观察性研究。在冷却0、12、24和72小时采集血清标本。采用酶联免疫吸附法测定S100B和NSE水平。对出生后7-10天的存活婴儿进行磁共振成像。在出生后14天由儿童神经科医生进行标准化神经检查。采用多元线性回归分析来评估S100B和NSE水平与不良结局（死亡或严重磁共振成像损伤/显著神经功能缺损）之间的关系。通过受试者工作曲线分析确定截止值。纳入了中度至重度脑病新生儿（n = 75）。就诊时pH值中位数为6.9（范围6.5-7.35），Apgar评分中位数为1分钟、3分钟和5分钟。在所有时间点上，不良结局患者的NSE和S100B水平均较高。在控制了协变量后，这些结果仍然具有统计学意义，包括首发时的脑病等级、5分钟时的Apgar评分、初始pH值和临床癫痫发作。低体温期间血清S100B和NSE水平升高与脑病新生儿脑损伤的神经放射学和临床证据相关。这些脑特异性蛋白可能是脑损伤严重程度的有用的即时生物标志物。
To determine if early serum S100B and neuron-specific enolase (NSE) levels are associated with neuroradiographic and clinical evidence of brain injury in newborns with encephalopathy. Patients who received therapeutic whole-body hypothermia were prospectively enrolled in this observational study. Serum specimens were collected at 0, 12, 24, and 72 hours of cooling. S100B and NSE levels were measured by enzyme linked immunosorbent assay. Magnetic resonance imaging was performed in surviving infants at 7–10 days of life. Standardized neurologic examination was performed by a child neurologist at 14 days of life. Multiple linear regression analyses were performed to evaluate the association between S100B and NSE levels and unfavorable outcome (death or severe magnetic resonance imaging injury/significant neurologic deficit). Cutoff values were determined by receiver operating curve analysis. Newborns with moderate to severe encephalopathy were enrolled (n = 75). Median pH at presentation was 6.9 (range, 6.5–7.35), and median Apgar scores of 1 at 1 minute, 3 at 5 minutes, and 5 at 10 minutes. NSE and S100B levels were higher in patients with unfavorable outcomes across all time points. These results remained statistically significant after controlling for covariables, including encephalopathy grade at presentation, Apgar score at 5 minutes of life, initial pH, and clinical seizures. Elevated serum S100B and NSE levels measured during hypothermia were associated with neuroradiographic and clinical evidence of brain injury in encephalopathic newborns. These brain-specific proteins may be useful immediate biomarkers of cerebral injury severity.
登录
查看更多内容
影响因子：
168.9
作者：
Gluckman, PD;Wyatt, JS;Gunn, AJ
通讯作者：
Gunn, AJ
影响因子：
5.1
作者：
Miller, SP;Ramaswamy, V;Ferriero, DM
通讯作者：
Ferriero, DM
影响因子：
3.8
作者：
Maschmann, J;Erb, MA;Speer, CP
通讯作者：
Speer, CP
影响因子：
4.1
作者：
Berger, RP;Adelson, PD;Kochanek, PM
通讯作者：
Kochanek, PM
影响因子：
2.4
作者：
Azzopardi D;Brocklehurst P;Edwards D;Halliday H;Levene M;Thoresen M;Whitelaw A;TOBY Study Group
通讯作者：
TOBY Study Group