Significance Of Neuron-specific Enolase And Bilirubin/Albumin In Neonatal Hyperbilirubinemia

Objective:Investigate the relation between neuron-specific enolase,bilirubin/albumin and total serum bilirubin in neonatal hyperbilirubinemia and bilirubin encephalopathy,to evaluate the clinical application value between s-NSE and B/A in early prediction of bilirubin brain injury.Methods:90 cases of neonatal hyperbilirubinemia were studied from April 2017 to September 2017 in the neonatology department of Children's Hospital affiliated to kunming medical university,the diagnostic criteria of neonatal hyperbilirubinemia was refered to the fourth edition practice Neonatalogy.Selectd the period of physiological jaundice was not obvious(TSB<85 ?mol/L)of 30 cases of full-term neonatesas normal control group test.The corelation of s-NSE,B/A ratio with TSB between experimental group and control group were analysed by correlation analysis?The experimental group were divided into 3 subgroups according to the serum total bilirubin level,To Count the s-NSE,B/A ratio and TSB of each group,and analyse the results between each group by correlation analysis?The experimental group were divided into 2 subgroups according to the the diagnostic criteria of neonatal hyperbilirubinemia,to Count the s-NSE,B/A ratio and TSB of each group,and analyse the results between each group by correlation analysis?Results:1.The levels of NSE?B/A and TSB were significantly higher in the study group than in the control group(P=0.000).The levels of B/A and NSE were positively correlated with the level of TSB in study group.2.The levels of TSB were no significance between slightly elevated group and moderately elevated group(P<0.05);Severe hypertrophic group have significant difference between slightly elevated group and moderately elevated group(P=0.000);The levels of NSE and B/A has significant difference between slightly elevated group and moderately elevated group(P<0.05);Severe hypertrophic group have extremely significant difference between slightly elevated group and moderately elevated group(P=0.000);3.The levels of NSE?B/A and TSB in bilirubin encephalopathy group were significantly higher than non-bilirubin encephalopathy group(P=0.000).4.The areas under ROC curve of TSB?NSE?B/A and in combination were 0.932?0.710?0.897 and 0.933,are grater than 0.7,the three indicators have higher accuracy in bilirubin encephalopathy diagnosis,combined maximum of the three,the next is TSB.The corresponding sencitivity were 80%?92%?80%and 93%,the specific index were 89.2%?46.2%?82%and 90%?,it showed that the sensitivity index of the diagnosis of neonatal hyperbilirubinemia is combined maximum of the three>s-NSE>TSB=B/A,the specific index of the diagnosis of neonatal hyperbilirubine-mia is combined maximum of the three>TSB>B/A>s-NSE.Conclusion:1.The levels of NSE?B/A are increasing with the growth of bilirubin,which were positively increased in the moderately elevated group and severe hypertrophic group,all have positive correlation with the level of TSB,the levels of B/A ratio and the levels of NSE were positively correlated with the level of TSB in study group.lt showed that the clinical application value between NSE and B/A in early prediction of bilirubin brain injury.2.When the levels of TSB exceeded 256.5?mol/L,less than 342 p,mol/L,the levels of NSE?B/A were significantly higher,suggesting that brain damage may happen before the TSB does not reach 342?mol/L.3.The three indicators have higher accuracy in bilirubin encephalopathy diagnosis,combined maximum of the three,the next is TSB.4.The study suggest that the serum NSE and B/A were valuable markers in early prediction of bilirubin brain injury,which could provide a reference in early diagnosis and treatment of bilirubin brain injury.