精神分裂症患者立体定向手术前后神经元特异性烯醇化酶的改变

Changes of neuron-specific enolase before and after stereotactic operation in patients with Ⅱ form schizophrenia

目的 :探讨立体定向术对Ⅱ型精神分裂症患者脑脊液 (CSF)及血清中神经元特异性烯醇化酶 (NSE)的影响。方法 :应用立体定向术对 38例难治性精神分裂症患者进行治疗 ;酶联免疫吸附法测定手术前后患者CSF及血清中NSE浓度。结果 :Ⅱ型精神分裂症患者组手术前CSF和血清中NSE水平 (1 3.4 0± 4 .36 μg·L-1 ,1 6 .0 8± 5 .4 9μg·L-1 )显著高于对照组 (6 .95± 2 .38μg·L-1 ,1 1 .6 3± 3.87μg·L-1 )及Ⅰ型精神分裂症患者组 (7.4 9± 2 .35 μg·L-1 ,2 .4 2± 4 .2 8μg·L-1 ) ;手术后CSF及血清的NSE浓度(8.1 3± 2 .36 μg·L-1 ,1 2 .95± 3.6 8μg·L-1 )较手术前显著下降 (P <0 .0 1 ,P <0 .0 5 ) ,与对照组比较差异无显著性 (P >0 .0 5 ) ;Ⅱ型患者组CSF和血清NSE水平的变化呈明显正相关 (y =0 .883x +3.2 1 ,r=0 .4 0 1 ,P <0 .0 5 )。结论 :CSF和血清NSE水平测定对Ⅱ型精神分裂症患者的诊断有重要意义 ,立体定向手术可降低Ⅱ型精神分裂症患者CSF及血清的NSE浓度 。

Objective: To study the effect of stereotactic operation on neuron-specific enolase(NSE) in cerebrospinal fluid(CSF) and serum levels in patients with Ⅱ form schizophrenia. Methods:Thirty eight cases with schizophrenia were treated with stereotactic operation, before and after which CSF and serum NSE were determined with ELISA. Results: Serum and CSF levels of NSE(13.40±4.36 μg·L -1 , 16.08±5.49 μg·L -1 ) were significantly higher in patients with Ⅱ form schizophrenia before operation than that in control group(6.95±2.38 μg·L -1 ,11.63±3.87 μg·L -1 ) and Ⅰform schizophrenia(7.49±2.35 μg·L -1 ,12.42±4.28 μg·L -1 ).After operation, NSE levels in CSF and serum (8.13±2.36 μg·L -1 ,12.95±3.68 μg·L -1 ) in patients with Ⅱ form schizophrenia were significantly lower ( P <0.01, P <0.05) than that before operation and they showed no significant difference from that of normal controls and Ⅰform patients( P >0.05).There were markedly positive correlation between CSF and serum NSE(y=0.883x+3.21, r = 0.401 , P <0.05). Conclusion: NSE levels in CSF and serum is useful in diagnosing Ⅱ form schizophrenia and stereotactic operation is of great significance in treating schizophrenia.