癫痫持续状态患儿血清神经元特异性烯醇酶和脑SPECT改变的意义

Serum Neuron Specific Enolase and SPECT rCBF Imaging in Childhood Status Epilepticus

目的 探讨血清神经元特异性烯醇酶（ＮＳＥ）和单光子发射计算机断层仪（ＳＰＥＣＴ）脑血流显像改变在癫痫持续状态（ＳＥ）患儿中的价值。方法 用ＥＬＩＳＡ法检测ＳＥ患儿入院后第１，３，７天外周血ＮＳＥ浓度，用同位素９９ｍＴｃ标记，ＥＣＤ显像剂药盒进行脑血流显像。结果 ＳＥ患儿血清ＮＳＥ浓度第１天为（１５．１３± ６．２２）μｇ／Ｌ，较正常对照[（２．６４± ０．７７）μｇ／Ｌ］明显增高（Ｐ ＜ ０．０１）；第３，７天逐渐下降，至第７天基本达正常水平[（４３５±１６５）μｇ／Ｌ］。１５例行ＳＰＥＣＴ脑血流显像者，异常率为７３．４％。结论 ＳＥ患儿存在脑损伤，血清ＮＳＥ检测对诊断脑损伤有重要价值，动态检测可帮助判断预后。ＳＰＥＣＴ脑血流显像对脑部病灶部位判断意义较大，而判断脑损伤仅有辅助价值。

Objective To evaluate the diagnostic va lue of serum neuron specific enolase(NSE) and single photo emission computed tomography(SPECT) regional cerebral blood flow(rCBF) imaging in childhood status epilepticus(SE). Methods Serum NSE concentration was assayed in 28 children with SE and in 40 normal controls using E LISA. SPECT rCBF imaging was performed in 15 cases of SE. Results The mean serum NSE concentration in the SE patients [(15.13± 6.22) μg/L] was higher than that in normal cont rols [(2.64± 0.77) μg/L] on day 1(P < 0.01). However,it gradually reduced from day 3 and normalized on da y 7. SPECT rCBF imaging was abnormal in 11 of the 15 SE cases.Conclusions Serum NSE is a marker in the diagnosis of brain injury in children with SE. SPECT rCBF imaging may be useful in assessing the location of brain injury in children with SE.