The Changes And Significance Of Serum NSE And S-100B Protein In NRDS Premature Infants

Objectives:Through the detection of serum NSE and S-100B protein in premature infants with neonatal respiratory distress syndrome and compared with the preterm infants in the control group,to analyse the changes of serumNSE and S-100B protein in these infants,and to investigate whether the neonatal respiratory distress syndrome in preterm infants occurs with brain injury,so as to guide the clinic to help judge the baby's condition and give intervention treatment.Methods:Collected a total of 50 neonate respiratory distress syndrome premature infants hospitalized in the neonatology department of the Second Affiliated Hospital of Kunming Medical University from February 19,2016 to December31,2017 were collected as the NRDS group.The NRDS group of preterm infants were divided into 4 groups according to the result of craniocal ultrasound.The control group consisted of 30 preterm infants in the same period with no dyspnea,no asphyxia,no clinical manifestations of the nervous system,no bilirubin encephalopathy,no hypoglycemic brain injury,and premature rupture of fetal membranes for less than 12 hours.Roche electroche miluminescence analyzer and kit were used to detect serum NSE,while serum S-100B protein was detected by enzyme-linked immunosorbent assay.Both the NRDS group and the control group received 1.5 ml of femoral venous blood at the 12-hour admission,and 1.5ml femoral vein blood were pumped again in 48 hours and 72 hours after admission in NRDS group.The gestational age,sex,mode of delivery,weight,breathing,heart rate,body temperature,blood glucose,nervous system performance and blood gas analysis were recorded and SNAPPE-? was carried out in detail.Cranial ultrasound examination was performed on the 2-3 day after birth and reviewed every 1 weeks.The data are collected and collated with Excel.SPSS 22 statistical software package was used for statistical analysis.Results:1.Comparison of general data between NRDS group and control group:There were no significant difference in gender,mode of delivery,gestational age,and birth weight between the two groups of preterm infants(P>0.05);while the difference in body temperature,respiration,heart rate and blood gas at admission were statistically significant(P<0.05).2.Comparison of serum NSE and S-100B protein levels in the two groups of preterm infants:The serum NSE and S-100B protein levels in the NRDS group were generally higher than those in the control group,and the differences were statistically significant(P<0.05).3.Dynamic changes of serum NSE and S-100B protein in preterm neonates of the NRDS group:Serum NSE and S-100B protein levels in 12 hours of admission were generally higher than those of 48 hours and 72 hours,and the serum NSE and S-100B protein in the 48 hours group were generally higher than that in the 72 hours group,and the difference were statistically significant(P<0.05).4.Comparison of SNAPPE-? in two groups and the correlation between serum NSE,S-100B protein and SNAPPE-? in preterm infants of NRDS group:Within 12 hours after admission,the SNAPPE-? of premature infants in NRDS group was generally higher than that in control group.The difference were statistically significant(P<0.05).In preterm infants of the NRDS group,the serum levels of NSE and S-100B protein were significantly higher in the group with higher SNAPPE-?,and the differences were statistically significant(P<0.05).There were a low positive correlation between serum NSE,S-100B protein and SNAPPE-?.5.Correlation analysis between serum NSE,S-100B protein and duration Of ventilator supportive in preterm neonates of the NRDS group:The serum NSE and S-100B protein with long duration of ventilator support were generally higher than those with short duration of ventilator support treatment,the difference were statistically significant(P<0.05),and there were a low positive correlation between serum NSE,S-100B protein and duration of ventilator supportive.6.Relationship between serum NSE,S-100B protein and duration of craniocerebral injury in premature infants of NRDS group:There were gradual decreasing trends in serum NSE and S-100B protein(NSE12h>NSE48 h>NSE72h,S-100B12h>S-100B48h>S-100B72h)with shorter abnormal duration of craniocal ultrasound(0 group and 1-2W group);while serum NSE and S-100B protein show a gradually increasing trends(NSE72h>NSE 48h>NSE12h,S-100B72h>S-100B48h>S-100B12h)with longer cranial ultrasound abnormalities(>4W group).The differences were statistically significant(P<0.05)Conclusions:1.At the time of admission,the heart rate,respiration,blood gas pH value,serum NSE,S-100B protein and SNAPPE-? of the infants in the NRDS group were higher than those in the control group.In the NRDS group,there were a low positive correlation between serum NSE,S-100B protein,SNAPPE-? and duration of ventilator supportive.It suggested that the higher the serum NSE and S-100B protein it is,maybe the more severe the condition in the NRDS group and the longer the ventilator support may be required.2.In the NRDS group,serum NSE and S-100B protein levels during 12 hours of admission were generally higher than those of 48 hours and 72 hours,and the serum NSE and S-100B protein in the 48 hours group were generally higher than that in the 72 hours group.It suggested that NRDS may have tran sient brain injury at early stage,And the condition of NRDS premature infants gradually improved after treatment,so the serum NSEand S-100B protein were gradually decreased.3.There was a gradually decreasing trend in serum NSE and S-100B protein with shorter abnormal duration of craniocal ultrasound;while it showe a gradually increasing trend with longer cranial ultrasound abnormalities.It indicated that the condition of NRDS premature infants with lighter craniocerebral injury gradually improved after treatment,so the serum NSE and S-100B protein were gradually decreased.While the more severe craniocerebral injury,the higher the serum NSE and S-100B protein were,the longer the time to recover.4.The study shows that serum NSE and S-100B protein have a certain guiding significance for early prediction of NRDS premature infants with brain injury,and can gradually decrease with the improvement of the condition.It has a guiding role in the early detection of neonatal respiratory distress syndrome in neonates with brain injury and to intervene in the treatment of NRDS preterm infants.