神经元特异性烯醇化酶在中枢神经疾病中的作用

Usage of neuron specific enolase in diseases of central nerve

烯醇化酶是参与无氧酵解中的关键酶,它是由α,β,γ组成的5种二聚体同工酶,其中γγ型因其特异性地存在于神经元和神经内分泌细胞中,被称作为神经元特异性烯醇化酶(NSE)。分子量为78000。NSE在神经系统含量亦不同,表现为中枢神经系统含量大于周围神经系统。在许多中枢神经系统疾病,如:脑卒中、脑外伤、脑肿瘤,特别是脑胶质瘤和成神经细胞瘤患者中,因NSE从病变神经元中溢出进入外周血和脑脊液,使血清和脑脊液中NSE水平上升,故广泛用于中枢神经系统疾病的诊断和预后估计。另外,因NSE存在于神经内分泌细胞中,故被用作恶性肿瘤,特别是肺部肿瘤的检测,NSE是敏感性与特异性强的肿瘤标志物。在其他一些疾病,如:肝硬化、肝性脑病以及晕厥等疾病中含量也有变化,可能有助于疾病诊断与预后判断。

Enolase is an enzyme which plays a key role in anaerobic degradation.It has five isoenzymes which are set up by subunit.Among these five,is foung only in neuron and neuroendocrine cell,so gets the name of neuron specific enolase(NSE).The molecule weight of NSE is 78 000. The level of NSE varies with the different area of neurosystem,in central nerve the level of NSE is higher than in peripheral nerve. In many central neurosyetem diseases,for example,stroke,cerebral trauma and intracranial tumor,especially neuroglima and neuroblasma,level of NSE may change.That is because NSE may escape from the neuron involved and come out into blood and cerebral spinal fluid(CSF),then it can be found ascended in serum and CSF.Now NSE is widely used to diagnose and help to estimate the seriousness and prognosis of the disease.Also according to its existence in neuroendocrine cell,NSE can be used to diagnose malignant tumors,especially lung cancer,and becomes to be a useful tumor marker for its high sensitivity ang speciality.By the way,in many other diseases,such as liver cirrhosis,hepatic encephalopathy,syncope and so on,the level of NSE will change,so testing it may help us to give the diagnosis and prognosis.