儿童热性惊厥血清神经元特异性烯醇化酶变化及其临床意义研究

Clinic significance of serum neuron specific enolase change of children with febrile seizure

目的探讨神经元特异性烯醇化酶(NSE)在热性惊厥(FS)患儿的变化及其临床意义。方法根据惊厥发作次数、惊厥持续时间等将研究对象分为FS组(单纯FS、发作1次、抽搐时间小于15 min)、FS1组(复杂FS、发作2次、每次抽搐时间小于15 min)、FS2组(复杂FS、发作1次、抽搐时间大于15 min)和对照组,各50例。采用放射免疫分析法检测各组患儿血清NSE水平。结果 FS组患儿发作第1天及第7天血清NSE水平[分别为(15.16±1.68)、(14.96±1.65)ng/m L]与对照组[分别为(15.00±1.88)、(14.82±1.46)ng/m L]比较,差异均无统计学意义(P>0.05);FS1、FS2组患儿发作第1天血清NSE水平[分别为(19.90±3.63)、(27.44±9.34)ng/m L]明显高于对照组,差异均有统计学意义(P<0.05);FS2组患儿发作第1天血清NSE水平[(27.44±9.34)ng/m L]较FS1组[(19.90±3.63)ng/m L]高,差异有统计学意义(P<0.05);FS2组患儿发作第7天血清NSE水平[(16.61±3.32)ng/ml]仍高于对照组,差异有统计学意义(P<0.05)。结论单纯FS发作后血清NSE水平正常,但不能完全排除脑神经元损伤,复杂FS发作后有明显脑神经元损伤,长程发作较反复短时间发作神经元损伤更重。

Objective To investigate the change and its significance of serum neuron specific enolase（NSE）in children with febrile seizure（FS）. Methods According to the frequency and duration of FS,the research object was divided into four groups,i.e. group FS（simple FS,1 seizure lasting less than 15 min）,group FS1（complex FS,2 seizure lasting less than 15 min）,group FS2（complex FS,1 seizure lasting more than 15 min） and the control group,50 cases in each group. It was adopted radio-immuni-assay to detect the serum NSE concentration. Results The difference had no statistical significance in the concentration of serum NSE on the 1st and 7th days of FS between simple group FS and the control group[（15.16±1.68）,（14.96±1.65）ng/m L respectively]vs. [（15.00 ±1.88）ng/m L,（14.82 ±1.46）ng/m L respectively]（P〈0.05）,the concentrations of serum NSE in the group FS1,group FS2 on the 1stday was higher than those of the control group[（19.90±3.63）ng/m L vs.（27.44±9.34）ng/m L respectively].There was statistical significance in difference（P〉0.05）. The concentrations of serum NSE in the group FS1,group FS2, whose FS duration was over 15 min was higher than those whose FS was repeated and short（〉twice,〈15 min）[（27.44±9.34）ng/m L vs.（19.90±3.63）ng/m L], whose difference had statistical significance（P〈0.05）. The concentrations of serum NSE[（16.61±3.32）ng/m L] of the FS patients lasted over 15 min on the 7th day was higher than that of the control group,whose difference had statistical significance（P〈0.05）. Conclusion The serum NSE concentration after simple FS is normal. The neurons damage should be considered.The complex FS may lead to obvious neurons damage. The degree of long-time attack is heavier to neuron damage than that of repeated short-time occurrence.