ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (5): 404-407.doi: 10.3969/j.issn.1674-3865.2019.05.010

• 临床研究 • 上一篇    下一篇

S100B、神经元特异性烯醇化酶在小儿肺炎支原体肺炎合并中枢神经系统损害的临床研究

阮豫才,肖小兵,陈韶玲,邓建荣,杨志   

  1. 512026 广东 韶关,韶关市粤北人民医院儿科(阮豫才,肖小兵,邓建荣),神经内科(陈韶玲,杨志)
  • 出版日期:2019-11-01 发布日期:2019-11-08
  • 通讯作者: 肖小兵,E-mail:706492155@qq.com
  • 作者简介:阮豫才(1983-),女,医学硕士,主治医师。研究方向:小儿神经系统疾病、小儿感染性疾病的诊治
  • 基金资助:
    广东省韶关市卫生计划生育科研项目(Y17026)

Clinical study of S100B and NSE in children with Mycoplasma pneumoniae pneumoniacomplicated with central nervous system damage

RUAN Yucai,XIAO Xiaobing,CHEN Shaoling,DENG Jianrong,YANG Zhi   

  1. Department of Pediatrics,Yuebei People's Hospital,Shaoguan 512026,China
  • Online:2019-11-01 Published:2019-11-08

摘要:
目的
研究S100B、神经元特异性烯醇化酶(NSE)在小儿肺炎支原体肺炎(MPP)合并中枢神经系统损害脑脊液中的变化。
方法
收集2017年1月至2019年2月韶关市粤北人民医院儿科住院治疗的MPP合并中枢神经系统损害患儿35例作为观察组,同期选取MPP患儿40例为对照组。对两组入院时临床表现及相关辅助检查进行比较。MPP合并中枢神经系统损害患儿在急性期住院3 d内完成脑脊液S100B、NSE检查,治疗2周后复查;根据疾病转归比较治愈患儿和未愈患儿治疗前后脑脊液S100B、NSE的差异。
结果
观察组高热26例(74.3%),对照组高热19例(47.5%),观察组患儿高热发生率显著高于对照组,差异有统计学意义(P<0.05)。观察组患儿C反应蛋白升高35例(100.0%),显著高于对照组28例(70.0%),差异有统计学意义(P<0.05)。治疗14 d后治愈28例(80.0%),7例(20.0%)患儿仍有明显神经系统症状,其中意识水平障碍5例,精神行为及智力异常2例。NSE急性期住院3 d内治愈患儿与未愈患儿比较差异无统计学意义(P>0.05);治疗14 d后未愈患儿NSE较治愈患儿明显升高,差异有统计学意义(P<0.05);未愈患儿S100B无论是急性期住院3 d内,还是治疗14 d后均显著高于治愈患儿,差异有统计学意义(P<0.05)。
结论
MPP合并中枢神经系统损害患儿脑脊液NSE、S100B含量与病情严重程度相关,S100B在早期就明显异常。

关键词: 肺炎支原体肺炎, 中枢神经系统, S100B, NSE, 儿童

Abstract:
Objective
To study the level of S100B and NSE in cerebrospinal fluid of pneumonia mycoplasma pneumonia(MPP)complicated with central nervous system damage in children.
Methods
Totally 35 cases of MPP complicated with central nervous system damage were chosen as observation group, and 40 MPP children were included as control group; all the children were treated in Pediatric Department of Yuebei People's Hospital in Shaoguan from Jan. 2017 to Feb. 2019. The clinical manifestations on admission and the related auxiliary examinations were compared between the two groups. Examination of S100B and NSE in cerebral fluid was completed within 3 days of admission in MPP children with central nervous system damage at acute stage, and re-examination was carried out after 2 weeks of treatment. Based on the prognosis, the difference in S100B and NSE in cerebral fluid before and after treatment was compared between the cured children and the uncured children.
Results
In the observation group, there were 26 cases (74.3%) of high fever, whose incidence was significantly higher than that in control group (47.5%, 19 cases) (P<0.05). There were 35 cases (100%) of elevated C-reactive protein in observation group, significantly more than those in control group (28 cases, 70.0%) (P<0.05). After 14 days of treatment, 28 children (80.0%) were cured, while 7 (20.0%) still had obvious nervous symptoms, including 5 cases of disturbance of consciousness and 2 cases of abnormality in mental behavior and intelligence. There was no difference in NSE within 3 days of admission at acute stage between the cured children and uncured children (P<0.05). After 14 days of treatment, the NSE in uncured children was significantly higher than that in cured children (P<0.05); S100B in uncured children was significantly higher than that in cured children both within 3 days of admission at acute stage and at 14 days after treatment (P<0.05).
Conclusion
The content of NSE and S100B in cerebral fluid is related to the disease severity of MPP children with central nervous system damage, and S100B is obviously abnormal at the early stage.

Key words: Mycoplasma pneumoniae pneumonia, Central nervous system, S100B, NSE, Child