急性脑梗死患者血清同型半胱氨酸和神经元特异性烯醇化酶水平与梗死面积和神经功能缺损程度的关系

Relationship Between Serum Homocysteine and Neuron Specific Enolase Levels and Cerebral Infarction Area and Neurological Deficit Degree in Patients with Acute Cerebral Infarction

目的探讨急性脑梗死(ACI)患者血清同型半胱氨酸(HCY)、神经元特异性烯醇化酶(NSE)水平与脑梗死面积、神经功能缺损程度的关系。方法选取2018年1月至2019年12月在山东中医药大学第二附属医院神经内科住院的205例ACI患者,分别检测发病第1、7、14天血清HCY、NSE水平,根据MRI所示梗死面积分为小面积组(77例)、中面积组(81例)、大面积组(47例),根据美国国立卫生研究院卒中量表(NIHSS)评分分为轻型组(65例)、中型组(98例)及重型组(42例),分析血清HCY、NSE水平与梗死面积和NIHSS评分的关系。结果不同梗死面积患者第1、7天血清HCY、NSE水平差异有统计学意义(P<0.05)。第1、7天血清HCY水平与梗死面积呈正相关(r=0.517、0.496,P<0.01),血清NSE水平与梗死面积呈正相关(r=0.538、0.506,P<0.01)。第14天时血清HCY、NSE水平与梗死面积无关(P>0.05)。不同NIHSS评分患者第1、7天血清HCY、NSE水平差异有统计学意义(P<0.05)。第1、7天血清HCY水平与NIHSS评分呈正相关(r=0.533、0.519,P<0.01),血清NSE水平与NIHSS评分呈正相关(r=0.703、0.598,P<0.01)。第14天时血清HCY、NSE水平与NIHSS评分无关(P>0.05)。结论ACI患者早期血清HCY、NSE水平升高提示梗死面积较大及神经功能缺损程度较重。

Objective To investigate the relationship between serum homocysteine(HCY)and neuron specific enolase(NSE)levels and cerebral infarction area and neurological deficit degree in patients with acute cerebral infarction(ACI).Methods A total of 205 ACI patients who were hospitalized in the Neurology Department of Shandong University of Traditional Chinese Medicine Second Affiliated Hospital from January 2018 to December 2019 were selected.Serum HCY and NSE levels were detected on the 1st,7th,and 14th day of onset.According to the infarct size shown by MRI,they were divided into small area group(77 cases),medium area group(81 cases),and large area group(47 cases).According to the National Institute of Health Stroke Scale(NIHSS)score,they were divided into light group(65 cases),medium group(98 cases)and severe group(42 cases).The relationship between serum HCY and NSE levels and infarct size and NIHSS score was analyzed.Results The serum HCY and NSE levels of patients with different infarct sizes were statistically different on the 1st and 7th day(P<0.05).On the 1st and 7th day,serum HCY level was positively correlated with infarct size(r=0.517,0.496,P<0.01),and serum NSE level was positively correlated with infarct size(r=0.538,0.506,P<0.01).Serum HCY and NSE levels were not related to infarct size on the 14th day(P>0.05).The serum HCY and NSE levels of patients with different NIHSS scores were statistically different on the 1st and 7th days(P<0.05).On the 1st and 7th day,serum HCY level was positively correlated with NIHSS score(r=0.533,0.519,P<0.01),and serum NSE level was positively correlated with NIHSS score(r=0.703,0.598,P<0.01).Serum HCY and NSE levels on the 14th day had no relation with NIHSS score(P>0.05).Conclusion The increase of serum HCY and NSE levels in patients with ACI in the early stage of onset suggests that the infarct size is larger and the degree of neurological deficit is serious.