急性脑梗死病人S100B蛋白、NSE、Hcy和D-二聚体水平变化及其临床意义

Changes of S100B Protein,NSE,Hcy,and D-Dimer in Patients with Acute Cerebral Infarction and Their Clinical Significance

目的观察急性脑梗死(ACI)病人S100B蛋白、神经元特异性烯醇化酶(NSE)、同型半胱氨酸(Hcy)和D-二聚体水平变化,并探讨其临床检测价值。方法选取2015年9月—2017年9月我院马王堆院区神经内科收治的急性脑梗死病人108例,作为ACI组,选择同期健康体检者60名为对照组。检测受试者血清S100B蛋白、NSE、Hcy和血浆D-二聚体水平;采用美国国立卫生研究院卒中量表(NIHSS)评分评估神经功能缺损程度,根据NIHSS评分将108例ACI病人分为轻型梗死组(32例)、中型梗死组(62例)、重型梗死组(14例),根据患病后是否并发意识障碍分为伴意识障碍组(22例)与不伴意识障碍组(86例)。结果ACI组S100B蛋白、NSE、Hcy和D-二聚体水平明显高于对照组(P<0.05)。不同神经功能缺损组间S100B蛋白、NSE和D-二聚体水平比较,差异均有统计学意义(P<0.05),Hcy水平比较差异无统计学意义(P>0.05)。S100B蛋白、NSE和D-二聚体水平与NIHSS评分呈正相关(r=0.630,P=0.000;r=0.420,P=0.002;r=0.458,P=0.001)。伴意识障碍组D-二聚体水平高于不伴意识障碍组,差异有统计学意义(P<0.05)。结论S100B蛋白、NSE和D-二聚体可作为评价ACI病情严重程度的生物标志物,Hcy可作为辅助检查指标。

Objective To explore the clinical significance of S100B protein,neuron-specific enolase(NSE),homocysteine(Hcy),and D-Dimer(DD)in patients with acute cerebral infraction(ACI).Methods One hundred and eight ACI patients were selected as ACI group,and 60 healthy people were selected as control group in the same period.The levels of S100B protein,NSE,Hcy,and DD were detected.The degree of neurological impairment was assessed by National Institutes of Health Stroke Scale(NIHSS)score.The patients were divided into mild infarction group(32 cases),medium infarction group(62 cases),and severe infarction group(14 cases)according to NIHSS score,and divided into consciousness disorder group(22 cases)and without consciousness disorder group(86 cases).Results The levels of S100B protein,NSE,Hcy,and DD were higher in ACI group than those of control group(P<0.05).There were significant differences in S100B protein,NSE,and DD between different neurological impairment groups(P<0.05),but there was no statistically significant difference in Hcy level(P>0.05).The levels of S100B protein,NSE,and DD positively correlated with NIHSS score(r=0.630,P=0.000;r=0.420,P=0.002;r=0.458,P=0.001).The plasma DD level was significantly higher in patients with consciousness disorder than that in patients without consciousness disorder(P<0.05).Conclusion S100B protein,NSE,and DD could be used as biomarkers to evaluate the severity of ACI.Hcy can be used as an auxiliary index.