急性缺血性卒中患者血清NSE水平与侧支循环代偿分级关系研究

Relationship between serum NSE level and collateral circulation grade in patients with acute ischemic stroke

目的探讨急性缺血性卒中(AIS)患者血清神经元特异性烯醇化酶(NSE)水平与侧支循环代偿分级的关系。方法选取2018年3月至2019年9月在该院卒中中心行血管内治疗AIS患者40例为观察组,另选取40例健康志愿者为对照组。分别采用美国介入治疗神经放射学会/介入放射学会(ASITN/SIR)量表、改良Rankin评分量表(mRS)对观察组患者进行侧支循环代偿分级(分为侧支循环良好、不良组)及评估患者神经功能恢复情况(分为预后良好、不良组)。比较各组血清NSE水平的差异,并分析观察组患者血清NSE水平与侧支循环代偿分级的关系。结果观察组在发病后1、3、7、14 d血清NSE水平明显高于对照组;侧支循环代偿分级越高,血清NSE水平越低,侧支循环不良组(ASITN/SIR分级0~Ⅱ级)发病3、7 d血清NSE水平均显著高于侧支循环良好组(ASITN/SIR分级Ⅲ~Ⅳ级),差异均有统计学意义(P<0.05);预后良好组(mRS≥3分)入院后1、14 d血清NSE水平明显高于预后不良组(mRS≤2分),差异均有统计学意义(P<0.05)。结论AIS患者血清NSE水平可辅助判断患者侧支循环开放程度,可作为评估患者预后的参考指标。

Objective To research the relationship between serum neuron specific enolase(NSE)level and collateral circulation compensatory grade in patients with acute ischemic stroke(AIS).Methods From March 2018 to September 2019,forty patients with AIS who underwent endovascular treatment in the stroke center of the hospital were selected as the observation group,and forty healthy volunteers were selected as the control group.The American Society for Interventional Neuroradiology/Society of Interventional Radiology(ASITN/SIR)scale and the modified Rankin Rating Scale(mRS)were used to classify the observation group for collateral circulation compensation(divided into good or bad collateral circulation groups)And assess the recovery of patients′neurological function(divided into groups with good prognosis or poor prognosis).The differences in serum NSE level in different groups were compared,and the relationship between serum NSE level and collateral circulation compensation grade in the observation group were analyzed.Results The serum NSE level of the observation group were significantly higher than those of the control group at 1,3,7,and 14 days after the onset of the disease;the collateral compensation grade was higher,the serum NSE level was lower,and the serum NSE level of the poor collateral circulation group(ASITN/SIR grade 0-ⅡGrade)at 3 and 7 days after the onset of the disease were significantly higher than those of the good collateral circulation group(ASITN/SIR gradeⅢ-Ⅳ),the differences were statistically significant(P<0.05);the serum NSE level of the good prognosis group(mRS≥3 after )admission were significantly higher than those of the poor prognosis group(mRS≤2 points)on the 1st and 14th day after admission,and the differences were statistically significant(P<0.05).Conclusion Serum NSE level in patients with AIS can assist in judging the degree of collateral circulation opening in patients,and can be used as a reference indicator for evaluating the prognosis of patients.