急性脑卒中患者血清神经元特异性烯醇化酶浓度测定

Measurement of serum neuron-specific enolase levels in patients with acute stroke

目的测定急性脑卒中患者血清神经元特异性烯醇化酶(NSE)浓度并探讨其临床意义。方法应用酶联免疫反应法测定62例急性脑卒中患者发病3d内血清NSE浓度,同时按中国卒中评分标准进行神经功能缺损评分。结果(1)急性脑卒中患者血清NSE浓度23．25±8．91 μg／L与对照组6．98±2．11 μg／L相比明显增高(P<0．01),脑梗死24．31±9．41μg／L和脑出血23．13±8．03 μg／L两组之间血清NSE浓度无显著性差异(P>0．05);(2)急性脑卒中患者血清NSE浓度与脑梗死灶大小、脑出血血肿量及神经功能缺损程度明显相关(均P<0．01);(3)急性脑卒中患者血清NSE浓度与发病30 d Barthel指数评分无相关性(rS=-0．02,P=0．11)。结论急性脑卒中患者发病早期血清NSE浓度升高与脑损害和病情严重程度有密切关系。

Objective To explore the clinical value of serum neuron-specific enolase（NSE） levels in patients with acute stroke. Methods Serum NSE levels of 62 patients（40 with cerebral infarction, and 22 with intracerebral hemorrhage） were measured by ELISA in the first 3 days of stroke onset, and the neurological function was assessed with Chinese stroke scale at the same time. Results （1） Serum NSE levels were significantly higher in patient group 23.25±8.91 μg/L than those in control 6.98±2.11 μg/L（P 〈 0.01）. No significant difference was found in serum NSE levels between cerebral infarction group 24.31±9.41μg/L and intracerebral hemorrhage group 23.13±8.03 μg/L（P 〉 0.05）; （2） NSE levels in patient group were remarkably associated with infarct size, hematoma volume and neurological scale score; （3） There was no correlation between serum NSE levels and Barthel Index scores measured on day 30 after onset（r8 = -0.20, P = 0.11）. Conclusion Serum NSE level at the early stage of acute stroke may reflect the extent of brain damage and indicate the severity of the disease.