Clinical Significance Of Serum NSE,B/A And NBNA In The Newborn Infants With Hyperbilirubinemia

Objective:To explore the potential role of serum neuron specific enolase(NSE),total bilirubin/ albumin(B/A)ratio and neonatal behavioral neurological assessment(NBNA)through the different ages and different levels of neonatal hyperbilirubinemia in the newborn infants.Early detection of bilirubin-related brain damage in the newborn with hyperbilirubinemia provide evidence for primary local hospital.Methods: A total of 96 newborn infants with hyperbilirubinemia,51 cases were male and 45 females were collected from Department of Neonatology in Xuancheng Central Hospital Hospital from September 2015 to January 2016.According to days of age,a total of 44 cases of neonatal divided according to group A(24-72 hours)and 52 cases to group B(72-168 hours).Group A and group B was divided into 6 group(A1-A3,B1-B3)according to the level of total serum bilirubin.The level of TSB in the group A1/B1 was 220.6 to 257?mol/L,257-342?mol/L was define group A2/B2 and more than342?mol/L was define group A3/B3.Serum level of NSE by ELISA method,total serum bilirubin(TSB),B/A ratio were detected and NBNA score was assessed for the newborn when the day of admission.According to the degree of jaundice and phototherapy gave the newborn proper treatment of jaundice and probiotics(all cases that were not used phenobarbital jaundice).All cases conducted second blood test to detect the NSE after admitted to hospital 72 hours.When the newborn to 28 days old,all cases assessed the NBNA score again.Under the same days of age of the newborn and at the same bilirubin levels,comparative analysis of both groups under different subgroups the difference of NSE,B / A ratio and NBNA score.Results:1.In the same day of age range,according to different in the bilirubin levels of group A: serum level of NSE1,B/A ratio,NBNA1 and NBNA2 in group A1,group A2 and group A3 were significant different(P<0.05)based on the ANOVA.Bonferroni method was used formultiple comparisons.Serum level of NSE1 between group A1 and A2 and between A2 and group A3 were no significant different(P>0.05).Serum level of NSE1 between group A1 and A3 were significant different(P<0.05).B/A ratio between group A1 and A2 and between A2 and group A3 and between A2 and group A3 were significant different(P<0.05).No significant different of NBNA1 was fund between group A1 and A3(P>0.05).No significant different of NBNA1 was fund between group A2 and A3(P>0.05).NBNA1 between group A1 and A3 was significant different(P<0.05).NBNA2 between group A1 and A3 was significant different(P<0.05).No significant different of NBNA2 was fund between group A1 and A2(P>0.05).No significant different of NBNA2 was fund between group A2 and A3(P>0.05).2.In the same day of age range,according to different in the bilirubin levels of group B: serum level of NSE1,B/A ratio,NBNA1 and NBNA2 in group B1,group B2 and group B3 were significant different(P<0.05)based on the ANOVA.Bonferroni method was used for multiple comparisons.Serum level of NSE1 between group B1 and B2 was no significant different(P>0.05).Serum level of NSE1 between group B2 and B3 were significant different(P<0.05).Serum level of NSE1 between group B1 and B3 were significant different(P<0.05).B/A ratio between group B1 and B2 and between B2 and group B3 and between B1 and group B3 were significant different(P<0.05).Significant different of NBNA1 was fund between group B1 and B2(P<0.05).Significant different of NBNA1 was fund between group B2 and B3(P<0.05).NBNA1 between group B1 and B3 was significant different(P<0.05).NBNA2 between group B2 and B3 was no significant different(P>0.05).No significant different of NBNA2 was fund between group B1 and B2(P>0.05).Significant different of NBNA2 was fund between group B1 and B3(P>0.05).3.In the same levels of bilirubin,serum level of NSE1,NSE2,B/A ratio,NBNA1 and NBNA2 in group A and group B was compared using two independent samples t-test:(1).Serum level of NSE1,NSE2,B/A ratio,NBNA1 and NBNA2 was compared between group A1 and B1.Significant different of NSE1,NSE2 was fund(P<0.05).Serum level of TSB,B/A ratio,NBNA1,NBNA2 was no significant different(P>0.05).(2).Serum level of NSE1,NSE2,B/A ratio,NBNA1 and NBNA2 compared between group A2 and B2.Significant different of NSE2 was fund(P<0.05).Serum level of NSE2,TSB,B/A ratio,NBNA1,NBNA2 was no significant different(P>0.05).(3).Serum level of NSE1,NSE2,B/A ratio,NBNA1 and NBNA2 was compared between group A2 and B2.Significant different of NSE1,NSE2 was fund(P<0.05).Serum level of TSB,B/A ratio,NBNA1,NBNA2 was no significant different(P>0.05).Conclusion: 1.In the same age range,with TSB increased,the serum level of NSE,B/A ratio was also increased.However,NBNA score was decrease.These indicators are associated with bilirubin-related brain damage.And the inspection and the method of those index is simple and easy to operate.It is suitable for primary hospital and can be used for screening and discovery of bilirubin-related brain damage for the high-risk newborn groups.2.With the increase of age,dynamic monitoring on the serum of NSE can be used to early detection of bilirubin-related brain damage.