脊柱骨折伴急性脊髓损伤患者血清NSE、S100B蛋白水平变化及意义

Changes and significance of serum NSE and S100B protein levels in patients with spinal fracture complicated with acute spinal cord injury

目的研究脊柱骨折伴急性脊髓损伤(spinal cord injury,SCI)患者血清神经元特异性烯醇化酶(NSE)、S100B钙结合蛋白(S100B)蛋白水平变化及意义。方法纳入2015年2月~2017年12月于本院治疗的70例脊柱骨折伴SCI患者,设为SCI组,选择同期年龄、性别配对的70例脊柱骨折未伴脊髓损伤以及正常体检人员,分别设为非SCI组以及对照组。分别于受伤后12h、24h、4d、7d、14d抽取4ml外周静脉血,对照组仅采集4ml空腹外周静脉血一次,检测血清NSE、S100B水平并比较分析。结果 SCI组与非SCI组受伤后24 h血清S100B、NSE水平均显著高于其他时间(P<0.05),且两组各时间点的S100B、NSE水平均显著高于对照组,表现为SCI组>非SCI组>对照组,差异有统计学意义(P<0.05)。结论脊柱骨折伴SCI患者的血清NSE、S100B蛋白水平均显著高于未伴脊髓损伤以及正常人群,且其血清水平24 h达到峰值,随后逐渐降低,此两项指标可用于脊柱骨折伴SCI的早期监测。

Objective To study the changes and significance of serum neuron-specific enolas (NSE) and S100 calcium binding protein B (S100B) protein levels in patients with spinal fracture complicated with acute spinal cord injury (SCI). Methods Seventy patients with spinal fracture accompanied by SCI treated in our hospital from February 2015 to December 2017 were selected as SCI group. Seventy patients with spinal fracture without spinal cord injury and normal physical examination were selected as non-SCI group and control group. Four mL peripheral venous blood was collected at 12, 24 hours, and 4, 7, 14 days after injury respectively. In the control group, only 4 mL fasting peripheral venous blood was collected once. Serum levels of NSE and S100B were detected and compared. Results The levels of serum S100B and NSE in SCI group and non-SCI group at 24 h after injury were significantly higher than those in other time points(P<0.05 ), and the levels of S100B and NSE in each time point of the two groups were significantly higher than those in the control group, which showed SCI group>non-SCI group>control group, with significant difference (P<0.05). Conclusion Serum NSE and S100B protein levels in patients with spinal fractures and SCI were significantly higher than those in personnel without spinal cord injury and normal population, and their serum levels peaked at 24 h, then gradually decreased, which can be used for early detection of spinal fractures with SCI.