脑梗死患者血清神经元特异性烯醇化酶的动态变化及临床意义

Dynamic change and its clinical significance of serum neuron-specific enolase in patients with cerebral infarction

目的 探讨缺血性脑卒中患者急性期血清神经元特异性烯醇化酶 (NSE)的动态变化及其意义。方法 临床确诊的脑梗死患者 75例 ,测量并计算其脑梗死体积 ,采集其发病后不同时间的静脉血 ,凝固后立即 3 0 0 0r/s离心 1 5min ,取血清 ,置 - 80℃保存 ,共 2 4 8份标本 ;对照组为同年龄组健康成人 ,共 30例 ,采集标本 30份。采用NSE酶联免疫分析法测定血清中NSE浓度。数据用均数±标准差表示 ,各组间比较用方差分析和t检验及相关分析法。结果 ①脑梗死组和对照组NSE浓度分别为 (7 2 5± 2 1 4 )ng/mL和 (3 97± 1 1 2 )ng/mL ,具有显著差异 (P <0 0 1 ) ;②血清NSE浓度与脑梗死体积呈正相关 ,梗死体积越大 ,NSE值越高 ,各组间比较 ,均P <0 0 5 ;③脑梗死后NSE呈现动态变化 ,发病 4h内变化不明显 ,6h后开始升高 ,2 4h后明显升高 ,2d时达高峰 ,并可持续到第 5～ 7天 ,1 4d时基本恢复到正常水平 ;④血糖水平与NSE之间有一定相关性 ,血糖水平高者 ,其NSE值亦高。⑤血清NSE水平与脑梗死患者的预后相关 ,NSE高的患者 ,其 2周时的预后较差。结论 脑梗死后患者血清NSE升高并呈现一动态变化 ,它与脑梗死的体积及患者的预后相关 ,且其变化早于影像学变化 ,可以作为脑梗死程度的依据之一 ,对确定临床治疗方案具有一?

Objective To investigate the dynamic changes and its clinical significance of serum neuron-specific enolase(sNSE)in the patients with cerebral infarction.Methods The trial group was 75 patients with cerebral infarction,and the control group was 30 healthy people.The venous blood was collected at different times after cerebral infarction to get the serum samples and measure the sNSE by means of ELISA method.Results ①The sNSE concentration of the trial group was significantly higher than that of the control group,which were(7 25±2 14)ng/mL and (3 97±1 12)ng/mL respectively, P <0 01;②There was a positive relationship between the sNSE concentration and the volume of the infarction.The bigger the infarction volume was,the higher the sNSE concentration was;③There were dynamic changes of the sNSE.Obvious changes of the sNSE concentration were not found within 4 hours after the infarction.They began to increase gradually after 6 hours and get the highest level in 2 days, persist for 5～7 days,which decreased to the normal level after 14 days;④There was a positive relationship between the blood sugar level and the sNSE concentration,the higher the blood sugar level was,the higher the sNSE concentration was.⑤The sNSE level was associated with the prognosis of the patients with cerebral infarction.Conclusion The sNSE concentration which had a dynamic change after cerebral infarction,and was associated with the infarction volume and the prognosis of the patients,and it changed early compared with CT or MRI scaning.We could decide the treatment according to the sNSE concentration.