神经元特异性烯醇化酶在急性有机磷中毒患者血清中的动态变化及临床意义

Dynamic Variation of Serum Neuron-Specific Enolase and Its Clinical Significance in Patients with Acute Organophosphate Poisoning

目的:探讨急性有机磷中毒患者血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)的变化及临床意义。方法:选择90例急性有机磷中毒患者作为病例组,另选90例健康成人作为对照组。180例研究对象均于入院即刻采集静脉血3.0mL;除第1天病死的8例患者外,其余172例研究对象均于第2、3、5、7天分别采集静脉血3.0mL。采用酶联免疫吸附法测定血清NSE浓度;采用光电比色法测定血清胆碱酯酶(ChE)浓度。结果:病例组中8例患者于入院当日病死,其NSE及ChE血清浓度分别为(131.72±10.84)ng/mL、(199±228)U/L。病例组中其余82例患者入院后第1、2、3天血清NSE的平均水平分别为(54.56±5.46)ng/mL、(36.18±5.27)ng/mL、(20.56±4.64)ng/mL,对照组相应时间点的NSE浓度分别为(9.72±3.92)ng/mL、(9.48±3.66)ng/mL、(9.86±3.62)ng/mL,两组间差异均有统计学意义(P<0.01)。病例组82例患者入院后第1、2、3天血清ChE的平均水平分别为(1628.60±112)U/L、(2113.59±324)U/L、(2474.75±711)U/L,对照组相应时间点的ChE浓度分别为(5982±215)U/L、(5651±136)U/L、(5783±764)U/L,两组间的差异均有统计学意义(P<0.01)。入院第1、2、3天轻、中、重度中毒患者的NSE浓度与ChE浓度呈显著负相关,与中毒程度呈正相关,相关系数(rs)>0.05,P<0.05。结论:血清NSE可作为诊治急性有机磷中毒的参考指标。

Objective：To explore the dynamic variation of serum neuron-specific enolase（NSE）and its clinical significance in patients with acute organophosphate poisoning.Methods：Ninety patients with acute organophosphate poisoning were enrolled into case group,and other 90 healthy subjects were enrolled as control group.Venous blood samples of 3.0mL were collected from the all 180 subjects at admission.Apart from the 8 patients died on day 1,the other 172 subjects underwent collection of3.0mL venous blood samples on day 2,day 3,day 5,day 7.Serum NSE concentration was measured by enzyme-linked immunosorbent assay,while cholinesterase（ChE）was determined by photoelectric colorimetry.Results：Eight patients in case group died on admission day,of whom the average concentration of NSE and ChE were（131.72±10.84）ng/mL,（199±228）U/L,respectively.Concentration of NSE of the rest 82 patients on day1,day2,day3 were（54.56±5.46）ng/mL,（36.18±5.27）ng/mL,（20.56±4.64）ng/mL,respectively,and concentration of the control group on the corresponding time points were（9.72±3.92）ng/mL,（9.48±3.66）ng/mL,（9.86±3.62）ng/mL,respectively.Statistically significant differences were detected between two groups（P〈0.01）.Average concentration of ChE of the rest 82 patients on day 1,day 2,day 3 were（1628.60±112）U/L、（2113.59±324）U/L、（2474.75±711）U/L,respectively,and those in the control group on the corresponding time points were（5982±215）U/L,（5651±136）U/L,（5783±764）U/L,respectively.Statistically significant differences were detected between two groups（P〈0.01）.The concentrations of NSE were in significantly negative correlation with that of ChE in mild,middle and severe poisoning patients on day 1,day 2,day 3,and in positive correlation with the poisoning severity.The correlation coefficients rs0.05,P〈0.05.Conclusions：Serum NSE may be used as an reference indicator in the diagnosis and treatment of acute organophosphate poisoning.