The Time Course Of Serum Neuron-specific Enolase In Newborns With Hypoxic-ischemic Encephalopathy

Objective: To evaluate the value for the time course of serum neuron-specific enolase (NSE) as a biochemical marker of hypoxic-ischemic brain damage in newbornsMethods: Serial analysis of serum NSE levels was performed by IRMA in 25 newborns with HIE at the 1st,2nd ,3rd, 5th and 7th day after birth ,controlled by serum NSE levels in 7 normal newborns at 1st day.The statistical methods were ANOVA and R*C x 2 tests.Results: 1. The serum NSE levels of 25 newborns with HIE had significantly increased in the first 3 days . There were double peeks of NSE levels at both the 1st and 3rd day. And the serum NSE concentrations decreased gradually as the patients got well at the 5th and 7th day.2. The time course of serum NSE levels of each group of newborns with HIE was different, and correlated with the degree of severity of illness. In the mild HIE, there was only one peak of NSE concentrations which happened at the 3rd day(P<0.05). In themoderate HIE, NSE levels measured in the first 3 days were significantly higher than those of 5th or 7th days(P<0.05). And there were 2 peaks at the 1st and 3rd day individually. But differences of concentration of each day in the first 3 days were not significant when compared each other(P>0.05). In the severe HIE, there were also 2 peaks of NSE concentrations at the 1st and 3rd day.,and the higher peak appeared at 1st day(P<0.05).3. The levels of NSE at different time points were different in every group. As the illness got worse, the NSE levels got higher. The maximum average NSE concentration appeared at the 1st day in the severe group.4. The outcome of patients with HIE correlated with the concentrations of serum NSE. And the NSE levels of dead group were higher significantly than those of the restored group. The area under ROC was 0.838 0.092(P<0.05) when the serum concentration of NSE of the 1st day was used as the predictor of death . At the 95% specificity level, the sensitivity was 62.5%.Conclusions: 1. The serum NSE levels can be used as an early biochemical predictor of HIE diagnosis and severity of brain damage in newborns.2. The serum NSE levels detected steadily can give some important informations in the practice of illness evaluation, the treatment decision and the prediction of prognosis.