[Urinary S100B protein and lactate/creatinine ratio measurements: a tool for the early identification of neonatal hypoxic-ischemic encephalopathy].
OBJECTIVE
To investigate the value of urinary S100B protein and lactate/creatinine ratio determination in early identification of neonatal hypoxic-ischemic encephalopathy (HIE).


METHODS
The levels of urinary S100B protein and urinary lactate/creatinine ratio were detected in 58 full-term newborn infants with HIE on the first, second and third day after birth. The severity of clinical manifestations, including the degree of encephalopathy, was assessed within 7 days after birth. Twenty five normal neonates were enrolled into the control groups.


RESULTS
(1) The urinary S100B level of HIE neonates was significantly higher in samples collected throughout the monitoring period than those of the normal control groups (all P < 0.001). The urinary lactate/creatinine ratio of the HIE neonates was also significantly higher than that of normal control groups within the first day (P < 0.001). (2) A significantly positive correlation was found between the level of urinary S100B protein within three days and the urinary lactate/creatinine ratio within the first day and between the level of urinary S100B protein within three days and clinical degree (P < 0.05). (3) When S100B concentration was 0.47 microg/L and urinary lactate/creatinine ratio was 0.55, the sensitivity and specificity of detecting the third day urinary S100B alone, were respectively 90.4%, 91.9%. Detecting it associated with the first day urinary lactate/creatinine ratio could increase the sensitivity and specificity (respectively 98.8% and 97.4%) for predicting development of HIE.


CONCLUSIONS
On the basis of clinical manifestations of asphyxic neonatals, detecting the level of urinary S100B within three days and the first day urinary lactate/creatinine ratio may be of important value in early diagnosis and grading of HIE.
Liu
Li
L
Department of Neonatology, The First Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
Zhou
Hong-yan
HY
Feng
Zhan-wei
ZW
He
Li
L
Su
Zu-you
ZY
D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000150:complications; D003404:Creatinine / Q000652:urine*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000209:etiology / Q000652:urine*; D007231:Infant, Newborn; D019344:Lactic Acid / Q000652:urine*; D008297:Male; D009414:Nerve Growth Factors / Q000652:urine*; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000652:urine*; D014057:Tomography, X-Ray Computed
D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human; D019344:Lactic Acid; D003404:Creatinine