心肺复苏后血清S-100蛋白和神经元特异性烯醇化酶检测对神经功能预后判定的临床意义

Clinical significance of S-100 protein and neuron-specific enolase serum level in the neurological outcome after cardiac pulmonary resuscitation

目的探讨心肺复苏后患者血清S-100蛋白和神经元特异性烯醇化酶(NSE)水平的变化与神经功能预后的关系。方法37例复苏成功心搏呼吸骤停患者,至少存活48h,按神经功能恢复程度分为三组,A组(n=7):神经功能恢复尚可,48h后GCS评分>5分,2周后完全康复或有轻度的神经功能障碍;B组(n=8):神经功能恢复不良,48h后GCS评分<5分,严重神经功能障碍,生活不能自理或植物状态;C组(n=22):2周内死亡。采用酶联免疫方法检测S-100蛋白和NSE水平。结果S-100蛋白检测结果分别为A组(1.87±0.07)μg/L、B组(2.96±0.11)μg/L和C组(2.96±0.11)μg/L,B组、C组与A组比较差异均有统计学意义(P<0.05,P<0.01);NSE检测结果分别为A组(24.46±2.91)μg/L、B组(35.29±3.14)μg/L和C组(39.75±3.60)μg/L,B组、C组与A组比较差异均有统计学意义(P<0.05,P<0.01)。结论血清S-100蛋白和NSE可作为判断心肺复苏后脑功能恢复的有价值的指标。

Objective To observe the change of serum concentration of S - 100 protein and neuroproteins neuron - specific enolase （NSE ） after cardiac pulmonary resuscitation （CPR ）, and to study the relationship between them and neurological outcome. Methods 37 cases were resuscitated from cardiac arrest and lived at least 48hours after resuscitation, who were divided into three groups according to the severity of neurological outcome, group A （ n = 7 ） ： good neurological recovery, Glasgow Coma Scale （GCS） 〉 5 48 h after resuscitation, complete recovery or slight neurological dysfunction two weeks later; Group B（ n = 8）： bad neurological recovery, Glasgow Coma Scale （GCS） 〈 5 48 h after resuscitation, severe neurological dysfunction or vegetative state; Group C（ n =22） ： died within two weeks. The serum concentrations of S - 100 protein and neuroproteins NSE were detected by enzyme - linked immunosorbent assay. Results S - 100 protein and NSE were （ 1.87 ±0.07） μg/L and （24.46 ±2. 91 ）μg/L in group A, （ 2.96 ± 0.11 ） μg/L and （ 35.29 ± 3.14 ）μg/L in group B and （ 2.96 ± 0.11 ） μg/L and （ 39.75±3.60 ）μg/L in group C. There were differences between group B and group A （ P 〈 0. 05）, and there were significant differences between group C and group A （ P 〈 0.01）. Conclusion The serum concentration of S - 100 protein and NSE after CPR is a valuable marker for the judgement of neurological outcome.