弥漫性轴突损伤患者血清S100B和神经元特异性烯醇化酶的变化及意义

Changes of serum neuron-specific enolase(NSE) and S100B in head trauma patients with diffuseaxonalinjury(DAI) and their clinical significance

目的:探计弥漫性轴突损伤(diffuseaxonalinjury,DAI)患者血清S100B和神经元特异性烯醇化酶(neuron specifis enolase,NSE)浓度的变化及临床意义。方法:选择符合DAI诊断标准的脑外伤患者46例,对照组为同期受伤20例单纯头皮挫裂伤,无失血性休克患者.按照格拉斯哥预后评分Ⅰ～Ⅲ级(死亡,植物生存,严重残残)为预后不良组18例;Ⅳ-Ⅴ级(轻-中度致残和完全恢复)为预后良好组28例;于损后1h,3h,6h,12h,24h和48h采血检测血清中S100B和NSE浓度。结果:与对照组比较,DAI组S100B蛋白在伤后1h就明显增高(P<0.01),并持续升高至伤后6h,但预后良好组12～24h有所下降(P>0.05),48h下降有统计学意义(P<0.05);预后不良组S100B蛋白持续不下降。而NSE于伤后3h开始升高(P<0.05),6h达高峰(P<0.01),预后良好组12h下降(P<0.01),24h降至正常;预后不良组NSE持续不下降。结论:DAI患者血清S100B蛋白和NSE含量明显升高,联合监测血清S100B和NSE蛋白含量的变化不但能准确地反映出脑损害和程度而且可以判断DAI的预后。

Objective: To investigate the changes of serum neuron-specific enolase (NSE) and S100B in head trauma patients with diffuseaxonalinjury(DAI) and their clinical significance. Mehtods:Forty-six cases of DAI were selected according to diagnostic criteria of DAI. The control group contained 20 cases with simple scalp lacerated wound,and none of them had hemorrhagic shock.The prognosis of 18 patients with Ⅰ～Ⅲ of Glasgow prognosis score(died, plant status and serious mutilation) was considered unfavourable,and th...