儿童惊厥脑脊液和血清中NSE的变化及其临床意义

Changes and clinical significance of neuron specific enolase in cerebr ospinal fluid and serum in seizures children

目的:探讨小儿惊厥发作时间,引起惊厥原因对脑神经元的损伤及其程度。方法:按照引起小儿惊厥的病因及惊厥发生持续的时间及次数进行分组。应用酶联免疫法和分光光度法测定惊厥发作后不同时间患儿脑脊液和血清中神经元特异烯醇化酶(Neuron-specific eno-lase,NSE)的含量。结果:除热性惊厥组外,所有惊厥患儿脑脊液及血清中的NSE明显高于正常对照组(P<0.05,P<0.01);无论任何原因引起惊厥,惊厥时间越长,脑脊液和血清中NSE越高,两者成正相关(r=78.3～81.6,P<0.01);在所有病因中,颅内感染者由于惊厥平均次数最多及平均持续时间最长,所以脑脊液及血清中NSE水平升高最明显,且持续时间最长,尤其是有昏迷或严重神经系统并发症者尤为突出,而热性惊厥者NSE则无明显升高或只有轻微升高。结论:惊厥发作时由于伴有不同程度神经元损伤,从而使脑脊液和血清中NSE水平升高,其程度与惊厥发作持续时间,引起惊厥病因及脑损伤程度成正相关。

Objective：To discuss the time of seizures in children,the reasons ca using seizures and the degree of neuronal damage. Methods：According to the etio logy of seizures in children and the duration and frequency of occurrence,This experiment was divided into several groups.Neuron-specificeno-lase levels in the cerebrospinal fluid and serum at different times after seizures in children were analysed by Enzyme-linked immunoassay assay and spectrophotometry. Results：In addition to the febrile seizures group,NSE levels in the cerebrospinal flu id and serum of all the seizure was significantly higher than the control group（ P0.05,P0.01）.Whatever reason,the longer the seizure,the higher NSE leve ls i n the cerebrospinal fluid and serum,it was a positive correlation（r=78.3-81. 6, P0.01）.In all causes,because of average number of seizures and the average du r ation up to a maximum,NSE levels in the cerebrospinal fluid and serum of intrac ranial infections was the most significant and longest duration,especially thos e with coma or severe neurological complications,While NSE of the febrile seizu res were no significantly higher or only slightly elevated. Conclusion：As seizures associated with different degrees of the neurons damage,NSE levels in CSF an d serum increased,there was positive correlation between the degree and duratio n of seizure,cause of seizures and brain injury.