NSE、S-100β在基底节区高血压脑出血患者中的作用研究

Study the Effect of NSE and S-100βin Patients with Hypertensive Intracerebral Hemorrhage in Basal Ganglia

目的:探讨神经元特异性烯醇化酶(NSE)、S-100钙结合蛋白β(S-100β)在基底节区高血压脑出血(HICH)患者中的作用。方法:选取2021年1月-2022年6月九江市第一人民医院收治的基底节区HICH患者作为研究观察组(n=60),根据神经功能缺损的严重程度分为轻度组(n=14)、中度组(n=30)、重度组(n=16),根据预后情况分为预后良好组(n=38)、预后不良组(n=22);另以同期于本院进行体检的健康人为正常对照组(n=56)。采用化学发光免疫分析法(CLIA)和酶联免疫吸附试验(ELISA)检测研究观察组术前、术后3、7 d及出院时和正常对照组体检时的血清NSE、S-100β水平。用Spearman相关性分析研究NSE、S-100β与神经功能缺损程度的相关性,用ROC分析研究NSE、S-100β评估预后的价值。结果:研究观察组各时间点的NSE、S-100β水平均明显高于正常对照组(P<0.05);研究观察组不同时间点NSE、S-100β水平比较,差异均有统计学意义(F=530.879、427.941,P<0.05)。轻度组NSE、S-100β水平均低于中度组和重度组,中度组NSE、S-100β水平均低于重度组,差异均有统计学意义(P<0.05)。基底节区HICH患者NSE、S-100β与美国国立卫生研究院卒中量表(NIHSS)评分呈明显正相关关系(r_(s)=0.544、0.506,P<0.05)。ROC分析显示,NSE、S-100β评估预后的AUC分别为0.865、0.731,敏感度分别为81.82%、90.91%,特异度分别为89.47%、52.63%。结论:NSE、S-100β可以反映基底节区HICH患者的神经功能缺损程度,可为临床治疗进展及预后评估提供应用价值。

Objective:To investigate the effect of neuron specific enolase(NSE)and S-100 calcium binding proteinβ(S-100β)in patients with hypertensive intracerebral hemorrhage(HICH)in basal ganglia.Method:Patients with HICH in basal ganglia admitted to Jiujiang NO.1 People’s Hospital from January 2021 to June 2022 were selected as the research observation group(n=60).According to the severity of neurological deficits,they were divided into mild group(n=14),moderate group(n=30),severe group(n=16),and according to the prognosis,they were divided into good prognosis group(n=38)and bad prognosis group(n=22).In addition,the healthy people who had physical examination in our hospital in the same period were taken as the normal control group(n=56).The chemiluminescence immunoassay(CLIA)and enzyme linked immunosorbent assay(ELISA)were used to detect the serum NSE and S-100βlevels in the research observation group before operation,3 and 7 d after operation,discharge and during physical examination in the normal control group.Spearman correlation analysis was used to study the correlation between NSE and S-100βand the degree of neurological deficit,and ROC analysis was used to study the prognostic value of NSE and S-100β.Result:The NSE and S-100βlevels in the research observation group at each time point were significantly higher than those in the normal control group(P<0.05).Compared with the NSE and S-100βlevels in the research observation group at different time points,the differences were statistically significant(F=530.879,427.941,P<0.05).The levels of NSE and S-100βin mild group were lower than those in moderate and severe group,and the levels of NSE and S-100βin moderate group were lower than those in severe group,the differences were statistically significant(P<0.05).There were significant positive correlation between NSE,S-100βand national institute of health stroke scale(NIHSS)score in patients with HICH in basal ganglia(r_(s)=0.544,0.506,P<0.05).ROC analysis showed that the AUC of NSE and S-100βrespectively was 0.865 and 0.731,the sensitivity respectively was 81.82%and 90.91%,and the specificity respectively was 89.47%and 52.63%.Conclusion:NSE and S-100βcan reflect the degree of neurological deficit in patients with HICH in basal ganglia,and can provide application value for clinical treatment progress and prognosis evaluation.