急性脑梗死患者治疗前后血清神经元特异性烯醇化酶S100B蛋白水平的变化

Changes of serum neuron-specific enolase and S100B protein levels of patients with acute cerebral infarction before and after medical treatment

目的探讨急性脑梗死患者治疗前后血清神经元特异性烯醇化酶(NSE)、S100B蛋白水平的变化。方法选择2010年1月～2013年3月浙江省三门县人民医院急诊科急性脑梗死患者50例(病例组)予以控制颅内压、血压和血糖、抗血小板聚集、保护脑细胞及防治并发症等对症支持治疗2周。根据脑梗死灶面积大小≥5 cm2和<5 cm2分为大面积组(21例)和小面积组(19例)。比较患者治疗前后血清NSE、S100B蛋白水平和脑梗死灶大小的变化,并观察病例组脑梗死灶面积与NSE、S100B蛋白水平的关系。选择同期体检的健康体检者30例作为健康组,比较其与病例组血清NSE、S100B蛋白水平的差异。结果①病例组患者治疗前血清NSE、S100B蛋白水平[(32.57±7.12)、(2.15±0.43)ng/mL]明显高于健康组[(7.34±1.98)、(0.34±0.07)ng/mL],差异有高度统计学意义(t=7.26、8.92,P<0.01)。治疗2周后,病例组患者血清NSE、S100B蛋白水平[(18.72±3.65)、(0.97±0.18)ng/mL]均较治疗前[(32.57±7.12)、(2.15±0.43)ng/mL]明显下降,且治疗后脑梗死灶面积[(4.37±1.06)cm2]亦较治疗前[(5.75±1.58)cm2]明显减少,差异有统计学意义(t=3.12、5.31、2.34,P<0.05或P<0.01)。②病例组脑梗死灶大面积组NSE、S100B蛋白水平[(38.56±8.14)、(2.38±0.49)ng/mL]明显高于小面积组[(24.30±6.17)、(1.83±0.38)ng/mL],差异有统计学意义(t=2.87、2.30,P<0.05或P<0.01)。结论急性脑梗死患者存在血清NSE、S100B蛋白水平异常升高,其水平与脑卒中灶面积有一定的关系,可作为急性脑梗死程度、面积、疗效评价和预后估计的血清学标记物。

Objective To discuss the changes of serum neuron-specific enolase（NSE） and S100B protein levels of patients with acute cerebral infarction before and after medical treatment. Methods 50 cases of patients with acute cerebral infarction from January 2010 to March 2013 in People＇s Hospital of Sanmen County were selected as case group,and were given the symptomatic treatment,such as the control of intracranial pressure,blood pressure and blood glucose anti-platelet aggregation,brain cells protection,prevention and treatment of complications,and other treatments for 2 weeks. According to the size of cerebral infarction area（≥5 cm^2or 5 cm^2）,large area group（21 cases） and small area group（19 cases） were divided,The changes of serum NSE and S100B protein levels and the sizes of cerebral infarction of patients before and after medical treatment were compared,the relationship between infarction area in case group,serum NSE and S100B protein levels were observed. Additionally,30 cases of healthy people who were taking the physical examination at the same period were selected as health group,and the serum NSE and S100B protein levels of health group were compared with case group. Results ①The serum NES and S100B protein levels of patients in case group [（32.57±7.12） ng/mL,（2.15±0.43） ng/mL] were higher than those in health group [（7.34±1.98） ng/mL,（0.34±0.07） ng/mL],the differences were statistically significant（t = 7.26,8.92,P 0.01）. The serum NSE and S100B protein levels of patients in case group 2 weeks after the medical treatment [（18.72±3.65） ng/mL,（0.97±0.18） ng/mL] were obviously lower than those of before treatment [（32.57±7.12） ng/mL,（2.15±0.43） ng/mL],and the infarction area after medical treatment [（4.37±1.06） cm^2] was smaller than those of before medical treatment [（5.75±1.58） cm^2],the differences were statistically significant（t = 3.12,5.31,2.34,P 0.05 or P 0.01）. ②The NSE and S100B protein levels in large area group [（38.56±8.14） ng/mL,（2.38±0.49） ng/mL] was higher than those of small area group [（24.30 ±6.17） ng/mL,（1.83±0.38） ng/mL],the differences were statistically significant（t = 2.87,2.30,P 0.05 or P〈 0.01）. Conclusion The patients with acute cerebral infarction have abnormally high serum NSE and S100B protein levels,which have some correlation with stroke infarction. It is right to take the serum NSE and S100B as the serological markers of levels,areas,therapeutic and prognosis evaluation of acute cerebral infarction.