NSE、Hcy及D-二聚体在脑挫裂伤患者中表达及其预后分析

Expression and Prognosis of NSE,Hcy and D-dimer in Contusion and Laceration of Brain

目的研究颅脑手术对脑挫裂伤(cerebral contusion and laceration,CCL)患者的影响。方法便利选择2019年3月—2020年11月就诊于该院的82例CCL患者为研究组,另外选取该院体检中心40名健康者作为对照组。检测并比较研究组和对照组的血清中神经元特异性烯醇化酶(NSE)、同型半胱氨酸(Hcy)、D-二聚体的表达水平,并分析脑挫裂伤患者的意识、血压、脑挫裂伤面积、出院1个月预后、出院3个月预后及出院6个月的预后效果。对于CCL患者采用颅脑手术,并观察术后血清中的NSE、Hcy、D-二聚体的表达水平。结果与对照组相比较,研究组血清中NSE、Hcy及D-D表达水平均高,差异有统计学意义(P<0.05)。脑挫裂伤合并高血压、意识障碍患者的NSE、Hcy及D-D水平均高于血压、意识正常患者组,差异有统计学意义(P<0.05)。合并大面积脑挫裂伤患者脑组织中NSE、Hcy及D-D表达水平高于非大面积脑挫裂伤患者组,差异有统计学意义(P<0.05)。脑挫裂伤患者出院后1个月随访,死亡12例,存活70例,且死亡组脑挫裂伤患者脑组织中NSE、Hcy及D-D表达水平高于存活组。颅脑手术后,CCL患者血清中的NSE、Hcy及D-D表达水平降低,差异有统计学意义(P<0.05)。脑挫裂伤患者出院后3个月随访,死亡20例,存活62例,且死亡组脑挫裂伤患者脑组织中NSE、Hcy及D-D表达水平高于存活组。脑挫裂伤患者出院后6个月随访,死亡30例,存活52例,且死亡组脑挫裂伤患者血清中NSE、Hcy及D-D表达水平高于存活组,差异有统计学意义(P<0.05)。结论CCL患者血清中NSE、Hcy及D-D水平明显升高,且颅脑手术后可以降低血清中NSE、Hcy及D-D表达水平。

Objective To study the effect of craniocerebral surgery on patients with cerebral contusion and laceration(CCL).Methods A total of 82 CCL patients who were treated in the hospital from March 2019 to November 2020 were conveniently selected as the study group.In addition,40 healthy people from the physical examination center of the hospital were selected as the control group.The expression levels of neuron-spectific enolase(NSE),homocysteine(Hcy)and D-dimer in the serum of the study group and the control group were detected and compared.The consciousness,blood pressure,area of cerebral contusion,1 month discharge,3 month discharge and 6 month discharge prognosis of patients with cerebral contusion and laceration were also analyzed.Brain surgery was used for CCL patients,and the expression levels of NSE,Hcy and D-dimer in the postoperative serum were observed.Results Compared with the control group,the expression levels of NSE,Hcy and D-D in the serum of the study group were all higher,the difference was statistically significant(P<0.05).The levels of NSE,Hcy and D-D in patients with cerebral contusion and laceration complicated with hypertension and disturbance of consciousness were higher than those in patients with blood pressure and normal consciousness,the difference was statistically significant(P<0.05).The expression levels of NSE,Hcy and D-D in the brain tissue of patients with large-area cerebral contusion and laceration were higher than those of the non-large-area cerebral contusion and laceration group,the difference was statistically significant(P<0.05).The patients with cerebral contusion and laceration were followed up 1 month after discharge,12 died and 70 survived.And the expression levels of NSE,Hcy and D-D in the brain tissue of patients with brain contusion and laceration in the death group were higher than those in the survival group.After craniocerebral surgery,the expression levels of NSE,Hcy and D-D in serum of CCL patients were decreased,the difference was statistically significant(P<0.05).The patients with cerebral contusion and laceration were followed up for 3 months after discharge,and 20 died and 62 survived.The expression levels of NSE,Hcy and D-D in the brain tissue of the patients with cerebral contusion and laceration in the death group were higher than those in the survival group.The patients with cerebral contusion and laceration were followed up 6 months after discharge,30 died and 52 survived.In addition,the expression levels of NSE,Hcy and D-D in the serum of patients with brain contusion and laceration in the death group were higher than those in the survival group,and the difference was statistically significant(P<0.05).Conclusion The levels of NSE,Hcy and D-D in serum of CCL patients are significantly increased,and the expression levels of NSE,Hcy and D-D in serum can be reduced after craniocerebral surgery.