脑梗死患者血清神经元特异性烯醇化酶、超敏C反应蛋白水平变化与神经功能缺损程度评分的相关性研究

Analysis of correlation between serum NSE,hs-CRP levels and NIHSS score in patients with cerebral infarction

目的探讨脑梗死患者血清神经元特异性烯醇化酶(NSE)、超敏C反应蛋白(hs-CRP)水平变化与神经功能缺损程度(NIHSS)评分的相关性.方法选择丽水市中心医院2017年1月至2019年1月收治的脑梗死患者63例为研究对象,依据NIHSS评分按照病情程度分为轻度13例,中度30例,重度20例;根据梗死面积分为大面积组16例,小面积组27例,腔隙性脑梗死组20例.另选择丽水市中心医院2017年1月至2019年1月健康体检者60例作为对照组.采用酶联免疫吸附法(ELISA法)测定NSE含量;采用免疫比浊法测定hs-CRP含量.比较脑梗死组和对照组血清NSE和hs-CRP水平,不同病情程度和不同梗死面积血清NSE、hs-CRP水平和NIHSS评分变化及血清NSE和hs-CRP变化与NIHSS评分的相关性.结果脑梗死组血清NSE[(21.34±3.27)ng/mL]和hs-CRP[(10.48±2.14)mg/L],均高于对照组的(6.23±1.08)ng/mL和(2.83±0.46)mg/L,差异均有统计学意义(t=34.061、27.095,均P<0.05);重度组血清NSE[(26.98±3.64)ng/mL]、hs-CRP[(15.36±2.57)mg/L]和NIHSS评分[(38.49±3.25)分],均高于中度组和轻度组,且中度组的血清NSE、hs-CRP和NIHSS评分[(20.98±3.21)ng/mL、(10.25±2.09)mg/L和(22.18±3.48)分]均高于轻度组的(12.64±2.78)ng/mL、(5.47±1.40)mg/L和(7.38±2.56)分,差异均有统计学意义(F=14.975、9.132、15.873,均P<0.05);大面积组血清NSE[(25.43±3.35)ng/mL]、hs-CRP[(16.54±2.71)mg/L]和NIHSS评分[(37.34±3.75)分],均高于小面积组和腔隙性脑梗死组,且小面积组的血清NSE、hs-CRP和NIHSS评分[(21.67±3.12)ng/mL、(10.86±2.21)mg/L和(21.25±3.26)分]均高于腔隙性脑梗死组的(13.45±2.97)ng/mL、(4.79±1.35)mg/L和(8.49±2.15)分,差异均有统计学意义(F=13.241、9.893、17.482,均P<0.05).血清NSE和hs-CRP与NIHSS评分呈线性正相关(r=0.829、0.713,均P<0.05).结论脑梗死患者血清NSE和hs-CRP水平升高,随着病情进展升高越明显,且NSE和hs-CRP与NIHSS评分呈线性正相关,认为NSE和hs-CRP对神经功能缺损程度、病情及梗死灶大小评估具有重要价值.

Objective To investigate the correlation between the changes of serum neuron specific enolase(NSE)and hypersensitive C-reactive protein(hs-CRP)levels and the degree of neurological deficit(NIHSS)score in patients with cerebral infarction.Methods From Januaiy 2017 to January 2019,63 patients with cerebral infarction admitted to Lishui Central Hospital were selected.According to NIHSS score,they were divided into 13 mild cases,30 moderate cases and 20 severe cases.According to infarction area,they were divided into large area group(16 cases),small area group(27 cases)and lacunar infarction group(20 cases).Another 60 cases underwent health examination in our hospital from January 2017 to Januai-y 2019 were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to determine the content of NSE,and immunoturbidimetric assay was used to determine the content of hs-CRP.The changes of serum NSE and hs-CRP levels in the cerebral infarction group and control group,serum NSE,hs—CRP levels and NIHSS scores in different severity and infarction area,and the correlation between serum NSE and hs—CRP changes and NIHSS scores were compared.Results The serum levels of NSE[(21.34±3.27)ng/mL]and hs-CRP[(10.48±2.14)mg/L]in the cerebral infarction group were significantly higher than those in the control group[(6.23±1.08)ng/mL,(2.83±0.46)mg/L](I=34.061,27.095,all P<0.05).The serum levels of NSE[(26.98±3.64)ng/mL],hs-CRP[(15.36±2.57)mg/L]and NIHSS score[(38.49±3.25)points]in the severe group were higher than those in the moderate group and mild group,which in the moderate group[(20.98±3.21)ng/mL,(10.25±2.09)mg/L and(22.18±3.48)points]were higher than those in the mild group[(12.64±2.78)ng/mL,(5.47±1.40)mg/L and(7.38±2.56)],the differences were statistically significant(F=14.975,9.132,15.873,all P<0.05).The serum levels of NSE[(25.43±3.35)ng/mL],hs-CRP[(16.54±2.71)mg/L]and NIHSS score[(37.34±3.75)points]in the large area group were higher than those in the small aiea group and lacunar infarction group,which in the small area group[(21.67±3.12)ng/mL,(10.86±2.21)mg/L and(21.25±3.26)points]were higher than those in the lacunar infarction group[(13.45±2.97)ng/mL,(4.79±1.35)mg/L and(8.49±2.15)points],the differences were statistically significant(F=13.241,9.893,17.482,all P<0.05).The serum levels of NSE and hs-CRP were positively correlated with NIHSS score(r=0.829,0.713,all P<0.05).Conclusion The levels of serum NSE and hs-CRP in patients with cerebral infarction increase with the progression of the disease,and there is a linear positive correlation between NSE and hs-CRP and NIHSS score.It is considered that NSE and hs-CRP are of great value in evaluating the degree of neurological impairment,the severity of the disease and the size of the infarct.