动态检测蛛网膜下腔出血患者血浆NSE的变化及其意义

Plasma Neuron-specific Enolase Levels after Subarachnoid Hemorrhage

目的 :观察蛛网膜下腔出血患者血浆神经元特异性烯醇化酶 (NSE)与病情严重程度及预后的关系。方法 :用双抗体免疫夹心法检测 4 2例蛛网膜下腔出血患者发病 3d内、第 5、7、10、14天血浆NSE水平并与对照组比较 ,同时观察血浆NSE含量与患者Hunt氏分级及GOS预后评分的关系。结果 :患者血浆NSE的高峰值出现在发病 5d以后 ,Hunt氏分级Ⅰ、Ⅱ级的患者血浆NSE在发病第 5 ,7d时较对照组高 ,P <0 .0 5 ,发病 3d内血浆NSE浓度与对照组无统计学差异 ;Ⅲ、Ⅳ、Ⅴ级患者的血浆NSE水平在发病 14d内均较对照组显著升高 ,且较Ⅰ、Ⅱ级的患者血浆NSE升高更明显 ,在第 14d时仍维持较高水平。患者平均血浆NSE浓度与病情严重程度成正比 (r =0 .5 7,P <0 .0 1) ,与患者的预后成正比 (r =0 .6 1,P <0 .0 1)。结论 :动态检测蛛网膜下腔出血患者血浆NSE有助于我们监测患者的病情变化。

Objective: To investigate the clinical relevance of plasma concentration of Neuron-specific Enolase(NSE) in patients with subarachnoid hemorrhage during the first 14 days after the acute event.Methods:Plasma samples were taken from 42 patients with subarachnoid hemorrhage. Serial plasma samples were collected within the first 3 days, the 5th,7th,10th,14th day after the symptom onset. NSE was determined with a sandwich-type enzyme immunoassay using a kit for the measurement of NSE. The correlation between the plasma NSE concentration and the severity (Hunt and Hess grade), the prognosis(Glasgow outcome scale) of patients were also studied. Results: Plasma NSE levels were significantly higher in patients with a poor neurological status. Patients with a good outcome had low plasma NSE levels throughout their courses. In poor outcome patients, high levels persisted until 14 days after the subarachnoid hemorrhage. Conclusion: The course of plasma NSE levels is seen as a relevant parameter for assessing the severity of the disease, the prognosis and reflect the clinical course.