NSE對(duì)預(yù)測(cè)新生兒高膽紅素血癥腦損傷的價(jià)值進(jìn)行系統(tǒng)評(píng)價(jià)
發(fā)布時(shí)間：2018-12-11 10:53
【摘要】：目的:新生兒高膽紅素血癥是新生兒時(shí)期的一種常見(jiàn)疾病。新生兒高膽紅素血癥會(huì)損害患兒多個(gè)器官,特別是血清游離膽紅素可引起腦損傷。膽紅素腦病是引起兒童智力發(fā)育落后、聽(tīng)力減弱的一個(gè)非常重要的原因。急性膽紅素腦病的早期的臨床表現(xiàn)常常缺乏特異性,對(duì)于膽紅素腦病的診斷則多依賴于其臨床表現(xiàn)。本文旨在研究神經(jīng)元特異性烯醇化酶(NSE)對(duì)預(yù)測(cè)新生兒高膽紅素血癥腦損傷的價(jià)值進(jìn)行系統(tǒng)評(píng)價(jià),為膽紅素腦病的盡早發(fā)現(xiàn)及治療提供依據(jù)。方法:計(jì)算機(jī)檢索CBM、萬(wàn)方數(shù)據(jù)庫(kù)、中國(guó)知網(wǎng)、MEDLINE、PUBMED和Embase,檢索從建庫(kù)至2016年9月止關(guān)于NSE與高膽紅素血癥關(guān)系的隨機(jī)對(duì)照研究。追蹤檢索文獻(xiàn)的參考文獻(xiàn),以盡量降低漏檢率。文獻(xiàn)的篩選、資料的提取以及對(duì)納入的實(shí)驗(yàn)進(jìn)行質(zhì)量評(píng)價(jià),并使用Rev Man 5.1進(jìn)行Meta分析。結(jié)果:共納入研究文獻(xiàn)22篇,其中僅1篇文獻(xiàn)研究腦脊液神經(jīng)元特異性烯醇化酶與膽紅素關(guān)系。Meta分析結(jié)果顯示:1血清膽紅素水平與NSE含量關(guān)系的研究:早產(chǎn)兒實(shí)驗(yàn)組NSE含量高于正常對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(MD 22.29,95%CI 0.23~24.35);足月兒不同膽紅素水平各亞組間實(shí)驗(yàn)組NSE含量高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義。2 NSE在評(píng)估新生兒高膽紅素血癥腦損傷價(jià)值方面的研究:BAEP異常組NSE含量高于BAEP正常組,差異有統(tǒng)計(jì)學(xué)意義(MD 50.64,95%CI 36.35~64.94);NBNA異常組血清、腦脊液NSE含量高于NBNA正常組;顱腦MRI異常組NSE含量高于顱腦核磁正常組,差異有統(tǒng)計(jì)學(xué)意義(MD107.31,95%CI 99.25~115.36)。結(jié)論:血清、腦脊液中NSE含量可以作為敏感指標(biāo)對(duì)膽紅素腦損傷即膽紅素腦病進(jìn)行判斷,在膽紅素對(duì)中樞神經(jīng)系統(tǒng)毒性的早期發(fā)現(xiàn)且給予積極地干預(yù)方面有著重要的意義。但目前的研究均未提及新生兒期血清、腦脊液NSE含量的正常值范圍,納入各研究均與對(duì)照組NSE含量進(jìn)行比較,因此關(guān)于新生兒血清NSE含量正常值范圍有待進(jìn)一步研究。
[Abstract]:Objective: neonatal hyperbilirubinemia is a common disease in neonatal stage. Neonatal hyperbilirubinemia can damage multiple organs, especially serum free bilirubin, which can cause brain damage. Bilirubin encephalopathy is a very important cause of mental retardation and impaired hearing in children. The early clinical manifestations of acute bilirubin encephalopathy often lack specificity, and the diagnosis of bilirubin encephalopathy depends on its clinical manifestations. The purpose of this study was to evaluate the value of neuron-specific enolase (NSE) in the prediction of neonatal hyperbilirubinemia brain injury, and to provide evidence for early detection and treatment of bilirubin encephalopathy. Methods: a randomized controlled study on the relationship between NSE and hyperbilirubinemia was conducted from the establishment of the CBM, Wanfang database, the Chinese information network, MEDLINE,PUBMED and Embase, from the establishment of the database to September 2016. Track the references of the retrieval documents to reduce the missed detection rate as far as possible. Literature screening, data extraction and quality evaluation of the included experiments were performed, and Meta analysis was performed using Rev Man 5.1. Results: a total of 22 articles were included in the study. Meta analysis showed that: (1) the relationship between serum bilirubin and serum bilirubin level: the NSE content in the experimental group was higher than that in the normal control group. The difference was statistically significant (MD 22.2995 CI 0.23 ~ 24.35); The content of NSE in the experimental group with different bilirubin levels in term infants was higher than that in the control group, and the difference was statistically significant. 2 the value of NSE in evaluating the brain injury of neonatal hyperbilirubinemia: the NSE content in the abnormal BAEP group was higher than that in the normal group of BAEP. The difference was statistically significant (MD 50.6495 CI 36.35 64.94); The content of NSE in serum and cerebrospinal fluid in abnormal NBNA group was higher than that in normal NBNA group, and the content of NSE in abnormal MRI group was higher than that in normal brain nuclear magnetic field group (MD107.31,95%CI 99.25, 115.36). Conclusion: the content of NSE in serum and cerebrospinal fluid can be used as a sensitive index to judge bilirubin brain injury, I. E. bilirubin encephalopathy, which has important significance in early detection of bilirubin toxicity to central nervous system and active intervention. However, none of the current studies mentioned the normal range of NSE content in serum and cerebrospinal fluid (CSF). All the studies were compared with the NSE content in the control group. Therefore, the normal range of serum NSE content in neonates needs to be further studied.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R722.1
本文編號(hào)：2372411
[Abstract]:Objective: neonatal hyperbilirubinemia is a common disease in neonatal stage. Neonatal hyperbilirubinemia can damage multiple organs, especially serum free bilirubin, which can cause brain damage. Bilirubin encephalopathy is a very important cause of mental retardation and impaired hearing in children. The early clinical manifestations of acute bilirubin encephalopathy often lack specificity, and the diagnosis of bilirubin encephalopathy depends on its clinical manifestations. The purpose of this study was to evaluate the value of neuron-specific enolase (NSE) in the prediction of neonatal hyperbilirubinemia brain injury, and to provide evidence for early detection and treatment of bilirubin encephalopathy. Methods: a randomized controlled study on the relationship between NSE and hyperbilirubinemia was conducted from the establishment of the CBM, Wanfang database, the Chinese information network, MEDLINE,PUBMED and Embase, from the establishment of the database to September 2016. Track the references of the retrieval documents to reduce the missed detection rate as far as possible. Literature screening, data extraction and quality evaluation of the included experiments were performed, and Meta analysis was performed using Rev Man 5.1. Results: a total of 22 articles were included in the study. Meta analysis showed that: (1) the relationship between serum bilirubin and serum bilirubin level: the NSE content in the experimental group was higher than that in the normal control group. The difference was statistically significant (MD 22.2995 CI 0.23 ~ 24.35); The content of NSE in the experimental group with different bilirubin levels in term infants was higher than that in the control group, and the difference was statistically significant. 2 the value of NSE in evaluating the brain injury of neonatal hyperbilirubinemia: the NSE content in the abnormal BAEP group was higher than that in the normal group of BAEP. The difference was statistically significant (MD 50.6495 CI 36.35 64.94); The content of NSE in serum and cerebrospinal fluid in abnormal NBNA group was higher than that in normal NBNA group, and the content of NSE in abnormal MRI group was higher than that in normal brain nuclear magnetic field group (MD107.31,95%CI 99.25, 115.36). Conclusion: the content of NSE in serum and cerebrospinal fluid can be used as a sensitive index to judge bilirubin brain injury, I. E. bilirubin encephalopathy, which has important significance in early detection of bilirubin toxicity to central nervous system and active intervention. However, none of the current studies mentioned the normal range of NSE content in serum and cerebrospinal fluid (CSF). All the studies were compared with the NSE content in the control group. Therefore, the normal range of serum NSE content in neonates needs to be further studied.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R722.1
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