The Diagnostic Value Of Serum S100B Protein And Neurone Specific Enolase In Neonatal Brain Injury

Objective To evaluate the diagnostic value of serum S100 B protein in neonatal hypoxic-ischemic encephalopathy,neonatal bilirubin encephalopathy and neonatal infectious brain injury.Methods A total of 209 full-term neonates definitely diagnosed brain injury,including 105 cases of neonatal hypoxic-ischemic encephalopathy,64 cases of neonatal bilirubin encephalopathy,and 40 cases of neonatal infectious brain injury,in neonatal intensive care unit(NICU)of the First Affiliated Hospital of Bengbu Medical College from September 2016 to November 2018 were selected as observation group and 44 full-term neonates diagnosed without newborn brain injury in the same period were selected as control group.The levels of serum S100 B protein and NSE were measured with electro-chemiluminescence immunoassay.The ROC curves were drawn and calculating the sensitivity,specificity of detection and the area under the ROC curve,to analyze the correlation of serum S100 B protein and NSE.Results(1)The levels of serum S100 B protein and NSE in observation group were significantly higher than those in control group(P<0.05).(2)The best threshold value of serum S100 B protein detection for diagnosis of neonatal brain injury,neonatal hypoxic ischemic encephalopathy,neonatal bilirubin encephalopathy and neonatal infectious brain injury were 420.00ng/L,420.00ng/L,410.50ng/L and 424.00ng/L respectively;sensitivity were 64.1%,55.2%,78.1% and 72.5%,respectively;specificity were 97.7%,97.7%,93.2% and 97.7%,respectively.The best threshold value of serum NSE detection for diagnosis of neonatal brain injury,neonatal hypoxic ischemic encephalopathy,neonatal bilirubin encephalopathy and neonatal infectious brain injury were 16.57?g/L,16.70?g/L,16.8?g/L and 16.11?g/L,respectively;sensitivity were 69.4%,77.1%,70.3% and 60.0%,respectively;specificity were 95.5%,95.5%,95.5% and 88.6%,respectively,and the sensitivity of combination of serum S100 B and NSE detection were 87.6%,86.7%,87.5% and 82.5%,respectively;specificity were 95.5%,97.7%,97.7% and 95.5%,respectively.(3)The area under the ROC curve of serum S100 B protein for diagnosis of neonatal brain injury,neonatal hypoxic ischemic encephalopathy,neonatal bilirubin encephalopathy and neonatal infectious brain injury were 0.866,0.809,0.937 and 0.899,respectively.The area under the ROC curve of serum NSE for diagnosis of neonatal brain injury,neonatal hypoxic ischemic encephalopathy,neonatal bilirubin encephalopathy and neonatal infectious brain injury were 0.840,0.892,0.839 and 0.728,respectively.The area under the ROC curve of combination of serum S100 B and NSE detection for diagnosis of neonatal brain injury,neonatal hypoxic ischemic encephalopathy,neonatal bilirubin encephalopathy and neonatal infectious brain injury were 0.963,0.964,0.975 and 0.958,respectively.(4)The area under the ROC curve of combination of serum S100 B and NSE detection were significantly larger than that of serum S100 B detection and that of serum NSE detection in each groups,and difference with statistical significance(P<0.05);the area under the ROC curve of serum NSE detection for diagnosis of neonatal hypoxic ischemic encephalopathy was larger than S100 B protein detection,and difference with no statistical significance(P=0.0649);the area under the ROC curve of serum S100 B protein detection for diagnosis of neonatal bilirubin encephalopathy and neonatal infectious brain injury was larger than NSE detection,and results were significant difference(P<0.05).Conclusion S100 B protein could be as markers of brain injury during neonatal period;in addition,the diagnostic value of the combination detection is better than single marker detection.The diagnostic value of serum S100 B protein is better than that of serum NSE when diagnose neonatal bilirubin encephalopathy and neonatal infectious brain injury.