急性脑卒中患者血清神经元特异性烯醇化酶、S-100B蛋白、髓鞘碱性蛋白水平的变化

Changes of the Levels of Serum Neuron Specific Enolase,S-100B Protein and Myelin Basic Protein in Acute Stroke Patients

目的探讨急性脑卒中患者血清神经元特异性烯醇化酶(NSE)、S-100B蛋白、髓鞘碱性蛋白(MBP)水平变化及其临床意义。方法回顾性对照分析发病在48 h内的45例急性脑卒中患者(其中脑梗死组19例,脑出血组15例,短暂性脑缺血发作组11例)血清NSE、S-100B蛋白、MBP水平变化及其与脑梗死、脑出血患者神经功能缺损程度的相关性。结果脑梗死组和脑出血组患者血清NSE、S-100B蛋白、MBP水平均较对照组有不同程度增高(P<0.05),而短暂性脑缺血发作组与正常对照组比较均无明显变化。脑梗死组和脑出血组患者中神经功能缺损较重的中重型亚组患者血清NSE、S-100B蛋白、MBP水平较轻型亚组水平高(P<0.05)。结论血清NSE、S-100B蛋白、MBP水平可作为急性脑卒中患者病情判断、预后评估的指标之一,对早期脑梗死与短暂性脑缺血发作也有鉴别诊断价值,尤其适用于无法进行影像学检查的脑卒中患者。

Objective To study the changes of the levels of serum neuron specific enolase （NSE）, S-100B protein and myelin basic protein （MBP） in acute stroke patients and their clinical significance. Methods A review comparison analysis of 45 cases with acute stroke within 48 hours （19 cases with cerebral infarction, 15 cases with intracerebral hemorrhage and 11 cases with transient ischemic attack） and the resulted changes of the levels of serum NSE, S-100B protein, MBP, and the correlation of the degree of neural function damage in cases with cerebral infarction or intracerebral hemorrhage. Results Levels of serum NSE, S-100B protein and MBP in cases with cerebral infarction or intracerebral hemorrhage increased respectively （P〈0.05）. However, in cases with transient ischemic attack, levels of serum NSE, S-100B protein and MBP showed no obvious changes. Levels of serum NSE, S-100B protein and MBP in the subgroup of moderate and serious cases with serious neural damage resulted from cerebral infarction and intracerebral hemorrhage were higher than those from the subgroup of less serious cases （P〈0.05）. Conclusions Serum NSE, S-100B protein, and MBP can be used as one of the indexes in the diagnosis and prognosis of acute stroke. It can also help discriminate and diagnose early stage stroke and transient ischemic attack, particularly applicable to patients with stroke who have no access to image checkup.