NSE对高血压病患者并发脑梗死的诊断和中医辨证的参考价值研究

The Reference Value of Neuron-specific Enolase for the Diagnosis of Cerebral Infarction and the Differentiation of Traditional Chinese Medicine Syndrome in Hypertensive Patients

目的研究神经特异性烯醇化酶(NSE)对高血压病患者并发脑梗死的辅助诊断和中医辨证的参考价值。方法收集174例原发性高血压病患者的临床资料,采用酶联免疫吸附法检测患者的血清NSE浓度。运用ROC曲线法判断NSE对高血压病人群并发脑梗死的辅助诊断价值、最佳临界值和诊断性能。并通过相关分析,探讨NSE与中医证候的相关性。结果高血压并发脑梗死组的血清NSE浓度显著高于无脑梗死组(4.49μg/L±1.23μg/L vs 3.20μg/L±2.01μg/L,P<0.01)。在高血压病人群中NSE诊断脑梗死的ROC曲线下面积为0.785,具有一定准确性(P<0.01)。NSE的最佳临界值为4.27μg/L,对应的敏感度为67.6%,特异度为81.8%。中医证候方面,痰证患者的血清NSE浓度显著高于非痰证患者(4.48μg/L±1.31μg/L vs 3.23μg/L±2.00μg/L,P<0.01)。相关分析显示,血清NSE浓度与痰证之间存在一定正相关关系(r=0.385,P<0.01)。结论在高血压病人群中NSE对脑梗死的辅助诊断和痰证的辨证具有一定参考意义。

Objective To study the reference value of neuron specific enolase （NSE）for the diagnosis of cerebral infarction and the differentiation of traditional Chinese medicine （TCM）syndrome in hypertensive patients.Methods Clinical data of 174 cases of patients with essential hypertension were col ected.The serum concentration of NSE was detected by Enzyme linked immunosorbent assay （ELISA）.The clinical value,the Optimal Operating Point （OOP）and discriminatory power of NSE to diagnose cerebral infarction were determined by using the Receiver Operating Characteristic （ROC）curves in hypertensive patients.Then the correlation between NSE and TCM syndromes were analyzed.Results Compared with non infarction group,the serum concentration of NSE was increased significantly in hypertension complicated with cerebral infarction group （4.49μg/L± 1.23μg/L vs 3.20μg/L± 2.01μg/L, P〈0.01）.The area under the curve was 0.785 with a certain accuracy （P〈0.01）.The OOP of NSE was determined and interpreted at 4.27μg/L,corresponding to 67.6% sensitivity and 81.8% specificity.Compared with non phlegm syndrome group,the serum concentration of NSE was increased significantly in phlegm syndrome group （4.48μg/L± 1.31μg/L vs 3.23μg/L± 2.00μg/L,P〈0.01）. Correlation analysis showed that there was a positive correlation between NSE and phlegm syndrome （r= 0.385,P〈0.01）.Con-clusion NSE has some reference value for the diagnosis of cerebral infarction and the differentiation of phlegm syndrome in hypertensive patients.