血清神经元烯醇化酶水平对急性脑梗死患者转归的预测价值

Predictive value of serum neuron-specific enolase to the outcome in acute cerebral infarction patients

目的 探讨血清神经元烯醇化酶（NSE）水平与急性脑梗死患者短期预后的相关性.方法 选择急性脑梗死患者100例,出院时根据评定改良Rankin量表评分（mRS评分）对患者进行分组,mRS评分0～2分为预后良好组,mRS评分3～6分为预后不良组.比较两组血清NSE水平以及临床资料.结果 预后良好组62例,预后不良组38例.两组年龄、性别、高血压病、2型糖尿病、高脂血症、缺血性心脏病、TIA、既往卒中、吸烟和喝酒史比较,差异无统计学意义（P均＞0.05）.预后不良组患者入院NIHSS为10.0分,NSE水平13.8 mg/L,预后良好组分别为4.0分和10.8 mg/L,P均＜0.01.多因素Logistic回归分析显示,NSE水平为预后不良患者的独立危险因素（OR=1.180,95％CI：1.029 ～ 1.351,P=0.017）.以血清NSE水平预测患者预后不良的Cutoff值为＞11.87 mg/L,其曲线下面积为0.732（P ＜0.001）.结论 血清NSE水平是判断急性脑梗死患者预后的良好生物指标.

Objective To explore the relationship between neuron-specific enolase（NSE） and short-term prognosis in acute cerebral infarction patients.Methods Choose 100 acute cerebral infarction patients,according to the quality of life of menopause rating scale （mRS） when they discharged from hospital,they were divided into good outcome group（mRS 0-2 scores） and bad outcome group（mRS 3-6 scores）.Compared the clinical features and serum NSE level of two groups.Results There were 62 patients in good outcome group and 38 patients in bad outcome group.There was no significant difference in age,gender,hypertensive disease,T2DM,hyperlipidemia,ischemic heart disease,TIA,prior stroke,smoking and drink history of two groups （P ＞ 0.05）.The NIHSS score and serum NSE level of bad outcome group were 10.0 scores,13.8 mg/L,and of bad outcome group were 4.0 scores,10.8 mg/L,P ＜0.01.Multi-factor Logistic Regression analysis showed that serum NSE level was the independent risk factor of patients with poor prognosis （OR =1.180,95％ CI：1.029-1.35,P =0.017）.In the acute phase independently predict short-term outcomes at discharge.According to ROC,of NSE for anticipating without good outcomes and the cutoff level that serum NSE level forecast poor prognosis was ＞ 11.87 mg/L,the area under curve was 0.732 （P ＜ 0.001）.Conclusions The serum NSE is a good biological indicators for anticipating the prognostic in acute cerebral infarction patients.