摘要
目的评价缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)新生儿早期的血清学辅助诊断指标包括肾上腺髓质素(adrenomedullin,ADM)、神经元特异性烯醇化酶(neuron specific enolase,NSE)及脑型肌酸激酶同功酶(creatine kinaes BB isozyme,CK-BB)的临床意义。方法选择57例临床诊断为HIE的新生儿在出生12h内抽血检测ADM、NSE和CK-BB,与62例非HIE的窒息新生儿和27例健康新生儿进行对照比较,计算单项或联合检测的敏感性和特异性,绘制ROC曲线,计算ROC曲线下面积。结果单指标检测,ADM对HIE的敏感性为87.72%,特异性为91.94%,优于NSE及CK-BB。ADM的ROC曲线下面积最大(面积0.917;95%可信区间0.868～0.967),临床诊断效能优于NSE及CK-BB。多指标联合检测,三指标联合检测敏感性可提高至98.25%,且敏感性和特异性之和最大。结论ADM为一高度敏感的HIE诊断血清学标志物,其与NSE和CK-BB联合检测,对于筛查和辅助诊断早期HIE有重要意义。
Objective To evaluate diagnostic sensitivity of three biomarkers （adrenomedullin （ADM）, neuron specific enolase （NSE） , creatiuc kinase BB isozyme （CK-BB） ） in detecting neonates with hypoxic-ischemic encephalopathy （HIE） . Methods Blood was drawn from 57 neonates clinically diagnosed with HIE 12 hours after birth to check ADM, NSE, and CK-BB, 62 asphyxiated neonates without HIE and 27 healthy neonates were also studied as control. The sensitivity and specificity of single or combined biomarkers were evaluated, ROC curves were protracted and the area below ROC curve was calculated. Results Single-biomarker detection showed that sensitivity and specificity of ADM were 87.72% and 91.94%, respectively, higher than NSE and CK-BB, with the largest area below ROC curve （area： 0.917; 95% credible interval 0.868 - 0.967）. Muhi-biomarkers detection showed that sensitivity could be raised to 98.25%, with the sum of sensitivity and specificity being the biggest. Conclusions ADM was a highly sensitive adjunctive marker for detecting HIE, and it has an important role in screening for early stage HIE patients when combinedwith NSE and CK-BB.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2009年第12期1147-1149,共3页
Journal of Clinical Pediatrics
