Changes And Clinical Importance Of Serum Neuron Specific Enolase And Brainstem Auditory Evoked Potential In Infants With Hyperbilirubinaemia

Objective To analyze the change in content of serum neuron specific enolase (NSE),bilirubin/albumine ratio as well as the transformation in brainstem auditory evoked potential(BAEP) according to different levels of serum total bilirubin (TB) within infants and, toinvestigate the relationship between changing in NSE and serum TB standards and the onebetween NSE and BAEP, so as to see the prognostic value of NSE.Methods Peripheral blood specimens from 89 jaundice infants in case group with TBlevel above 171.0μmol/L, which were divided into 4 subgroups by ranging from 171.0 to205.2 (group A), 205.2 to 256.5 (group B), 256.5 to 342.0 (group C) and 342.0 to more(group D), as well as 30 from non-jaundice infants as control were collected. Serum NSE wasmeasured by ELISA and the albumine was tested as routine way. The babies were givenBAEP test once or again when 3-4 months' old, basing on whether the initial test came out tobe abnormal. Then the relationship between changing in NSE and TB standards, and the onebetween NSE and BAEP were analyzed and investigated by statistic ways so as to see theprognostic value of NSE compared to bilirubin/albumine ratio.Results①NSE content in control and case group, as well as subgroup A, B, C, D were8.75±2.71 ng/ml, 15.94±4.73 ng/ml, 13.06±3.84 ng/ml, 14.11±3.65 ng/ml, 16.06±3.66ng/ml and 21.10±5.90 ng/ml respectively. There were significant differences between con-trol and case group (p=0.000), and within 4 subgroups (p=0.034, 0.000, 0.000, 0.000). NSEcontent was cubic curve correlated to TB level (Rsq=0.593, p=0.000). Regression equationwas Y=1.899+0.077X+1.76E-07X~3.③65 babies (130 ears) received BAEP tests and 84 ears (64.6%) were checked positive. Mild injury and peripheral type were commonly seen ingroup A,B,C,D with no significant differences (60.0%, 57.1%, 45.5%, 61.5%,p＞0.05/50.0%, 35.7%, 37.9%, 50.5%, p＞0.05). Parameters of BAEP had no significant differencesamong 4 subgroups except ILDV(p=0.000).③NSE had its best diagnostic value with86.0% sensitivity and 66.7% specificity at level of 14.36ng/ml. The AUC of NSE ROCC was0.844, significantly larger than the one for B/A 0.589 (p=0.000). Most babies withmild/moderate hearing loss recovered 3-4 months later. Content of NSE was higher in theinfants not recovered than the recovered ones and who passed the initial tests (t=2.4792,p=0.0184; t=6.9319, p=0.0000).Conclusion①Serum NSE content rise significantly in infants with bilirubin level higherthan 171.0μmol/L. There is cubic correlation between TB and NSE.②Mild and/orperipheral damage are the major manifestation of hearing loss in jaundice babies and, arelikely to recovered. That positive rate of heating loss, parameters of BAEP do not changeaccording to ascending TB level except ILDⅤ, which is shortening while TB is rising.③Changing of NSE content has a close relationship to the transformation of BAEP with ROCCAUC of 0.844 which shows good diagnostic value. There may be bilirubin induced nerveinjury when NSE level reaches or overpasses 14.36ng/ml (86.0% sensitivity and 66.7%specificity). Heating loss may be difficult to recover when it gets higher than 20.95±2.58ng/ml.