Serum neuron-specific enolase:A promising biomarker of silicosis

BACKGROUND Silicosis is a type of chronic pulmonary fibrosis caused by long-term inhalation of silica dust particles.There has been no ideal biomarker for the diagnosis and differential diagnosis of silicosis until now.Studies have found that elevated neuron-specific enolase(NSE)concentration in the serum of silicosis patients is helpful for diagnosis and severity assessment of the disease.However,the number of cases in these studies was not enough to arouse attention.AIM To investigate the clinical significance of serum NSE in the diagnosis and staging of silicosis.METHODS From January 2017 to June 2019,326 cases of silicosis confirmed in Quanzhou First Hospital Affiliated to Fujian Medical University were included in the silicosis group.A total of 328 healthy individuals or medical patients without silicosis were included in the control group.Serum NSE concentrations of all subjects were determined by electrochemical luminescence.RESULTS There were no significant differences in sex,age,smoking index and complications between the silicosis and control groups.The mean serum NSE concentration was 26.57±20.95 ng/mL in the silicosis group and 12.42±2.68 ng/mL in the control group.The difference between the two groups was significant(U=15187,P=0.000).Among the 326 patients with silicosis,103 had stage I silicosis,and the mean serum NSE concentration was 15.55±6.23 ng/mL.The mean serum NSE concentration was 21.85±12.05 ng/mL in 70 patients with stage II silicosis.The mean serum NSE concentration was 36.14±25.72 ng/mL in 153 patients with stage III silicosis.Kruskal-Wallis H test suggested that the difference in serum NSE concentration in silicosis patients in the three groups was significant(H=130.196,P=0.000).Receiver operating characteristic curve analysis indicated that the area under the curve was 0.858(95%confidence interval:0.828-0.888;P=0.000).When the NSE concentration was 15.82 ng/mL,the Jorden index was the largest,the sensitivity was 72%,and the specificity was 90%.CONCLUSION Serum NSE concentration may be a promising biomarker for the diagnosis and assessment of severity of silicosis.

Neuron-specific enolase expression in a rat model of radiation-induced brain injury following vascular endothelial growth factor-modified neural stem cell transplantation

BACKGROUND： Previous studies have shown that transplantation of vascular endothelial growth factor （VEGF）-modified neural stem cells （NSC） provides better outcomes, compared with neural stem cells, in the treatment of brain damage. OBJECTIVE： To compare the effects of VEGF-modified NSC transplantation and NSC transplantation on radiation-induced brain injury, and to determine neuron-specific enolase （NSE） expression in the brain. DESIGN, TIME, AND SETTING： The randomized, controlled study was performed at the Linbaixin Experimental Center, Second Affiliated Hospital, Sun Yat-sen University, China from November 2007 to October 2008. MATERIALS： VEGF-modified C17.2 NSCs were supplied by Harvard Medical School, USA. Streptavidin-biotin-peroxidase-complex kit （Boster, China） and 5, 6-carboxyfluorescein diacetate succinimidyl ester （Fluka, USA） were used in this study. METHODS： A total of 84 Sprague Dawley rats were randomly assigned to a blank control group （n = 20）, model group （n = 20）, NSC group （n = 20）, and a VEGF-modified NSC group （n = 24）. Rat models of radiation-induced brain injury were established in the model, NSC, and VEGF-modified NSC groups. At 1 week following model induction, 10 pL （5 ×10^4 cells/μL） VEGF-modified NSCs or NSCs were respectively infused into the striatum and cerebral cortex of rats from the VEGF-modified NSC and NSC groups. A total of 10μL saline was injected into rats from the blank control and model groups. MAIN OUTCOME MEASURES： NSE expression in the brain was detected by immunohistochemistry following VEGF-modified NSC transplantation. RESULTS： NSE expression was significantly decreased in the brains of radiation-induced brain injury rats （P 〈 0.05）. The number of NSE-positive neurons significantly increased in the NSC and VEGF-modified NSC groups, compared with the model group （P 〈 0.05）. NSE expression significantly increased in the VEGF-modified NSC group, compared with the NSC group, at 6 weeks following transplantation （P 〈 0.05）. CONCLUSION： VEGF-modified NSC transplantation increased NSE expression in rats with radiation-induced brain injury, and the outcomes were superior to NSC transplantation.

Flunarizine and lamotrigine prophylaxis effects on neuron-specific enolase, S-100, and brain-specific creatine kinase in a fetal rat model of hypoxic-ischemic brain damage

BACKGROUND： Calcium antagonists may act as neuroprotectants, diminishing the influx of calcium ions through voltage-sensitive calcium channels. When administered prophylactically, they display neuroprotective effects against hypoxic-ischemic brain damage in newborn rats. OBJECTIVE： To investigate the neuroprotective effects of flunarizine （FNZ）, lamotrigine （LTG） and the combination of both drugs, on hypoxic-ischemic brain damage in fetal rats. DESIGN AND SETTING： This randomized, complete block design was performed at the Department of Pediatrics, Shenzhen Fourth People＇s Hospital, Guangdong Medical College. MATERIALS： Forty pregnant Wistar rats, at gestational day 20, were selected for the experiment and were randomly divided into FNZ, LTG, FNZ ＋ LTG, and model groups, with 10 rats in each group. METHODS： Rats in the FNZ, LTG, and FNZ ＋ LTG groups received intragastric injections of FNZ （0.5 mg/kg/d）, LTG （10 mg/kg/d）, and FNZ （0.5 mg/kg/d） ＋ LTG （10 mg/kg/d）, respectively. Drugs were administered once a day for 3 days prior to induction of hypoxia-ischemia. Rats in the model group were not administered any drugs. Three hours after the final administration, eight pregnant rats from each group underwent model establishment hypoxia-ischemia brain damage to the fetal rats. Cesareans were performed at 6, 12, 24, and 48 hours later; and 5 fetal rats were removed from each mother and kept warm. Two fetuses without model establishment were removed by planned cesarean at the same time and served as controls. A total of 0.3 mL serum was collected from fetal rats at 6, 12, 24, and 48 hours, respectively, following birth. MAIN OUTCOME MEASURES： Serum protein concentrations of neuron-specific enolase and S-100 were measured by ELISA. Serum concentrations of brain-specific creatine kinase were measured using an electrogenerated chemiluminescence method. RESULTS： Serum concentrations of neuron-specific enolase, S-100, and brain-specific creatine kinase were significantly higher in the hypoxic-ischemic fetal rats, compared with the non-hypoxic-ischemic group. Serum concentrations of neuron-specific enolase, S-100, and brain-specific creatine kinase were significantly less in the FNZ, LTG, and FNZ ＋ LTG groups following ischemia, compared with the model group （P 〈 0.01）. However, these values were significantly greater in the FNZ and LTG groups, compared with the FNZ ＋ LTG group, following ischemia （P 〈 0.01）. CONCLUSION： Preventive antenatal use of oral FNZ and LTG has positive neuroprotective effects on intrauterine hypoxic-ischemic brain damage. The combined effect of these two drugs is superior.

ENO1蛋白及其相关活性位点缺失突变蛋白在昆虫杆状病毒表达系统中的表达与鉴定

目的:利用昆虫杆状病毒表达系统(昆虫BEVS)表达糖酵解酶α-烯醇化酶(ENO1)及其3种酶活性位点缺失突变的ENO1蛋白ENO1-M1、ENO1-M2和ENO1-M3,为后续宫颈癌的代谢治疗研究奠定基础。方法:利用分子克隆技术将优化后ENO1序列插入pFastBacTM1载体,获得含有目的基因的重组质粒pFastBac-ENO1。分别缺失ENO1发挥糖酵解酶功能的3个活性位点,进行优化后将其插入pFastBacTM1载体,获得3个活性位点缺失的重组质粒pFastBac-M1、pFastBac-M2和pFastBac-M3。通过转座、转染后获得重组杆状病毒rBV-ENO1、rBV-M1、rBV-M2和rBV-M3,利用WB法对目的蛋白的表达及特异性进行检测。结果:成功扩增重组杆粒rBacmid-ENO1、rBacmid-M1、rBacmid-M2和rBacmid-M3,获得大小约2000 bp的基因片段,与预期大小相符。昆虫BEVS可表达ENO1蛋白及其3个酶活位点缺失的重组蛋白ENO1-M1、ENO1-M2和ENO1-M3,其分子量约为52000,与预期相符。WB法鉴定这些蛋白能与特异性标签His-tag发生反应。结论:通过昆虫BEVS成功表达目的蛋白ENO1及其酶活性位点缺失蛋白ENO1-M1、ENO1-M2和ENO1-M3,这些蛋白具有反应原性,为后续测定这些蛋白与ENO1单抗亲和力创造了条件。

Use of neuron-specific enolase to predict mild brain injury in motorcycle crash patients with maxillofacial fractures: A pilot study

Purpose: Mild traumatic brain injury (TBI) is common but accurate diagnosis and its clinical consequences have been a problem. Maxillofacial trauma does have an association with TBI. Neuron-specific enolase (NSE) has been developed to evaluate neuronl damage. The objective of this study was to investigate the accuracy of NSE serum levels to detect mild brain injury of patients with sustained maxillofacial fractures during motor vehicle accidents. Methods: Blood samples were drawn from 40 healthy people (control group) and 48 trauma patients who has sustained isolated maxillofacial fractures and mild brain injury in motor vehicle accidents. Brain injuries were graded by Glasgow Coma Scale. In the trauma group, correlations between the NSE serum value and different facial fracture sites were also assessed. Results: The NSE serum level (mean ± SD, ng/ml) in the 48 patients with maxillofacial fractures and mild TBI was 13.12 ± 9.68, significantly higher than that measured in the healthy control group (7.72 ± 1.82, p < 0.001). The mean NSE serum level (ng/ml) in the lower part of the facial skeleton (15.44 with SD 15.34) was higher than that in the upper facial part (12.42 with SD 7.68);and the mean NSE level (ng/ml) in the middle-and lower part (11.97 with SD 5.63) was higher than in the middle part (7.88 with SD 2.64). Conclusion: An increase in NSE serum levels can be observed in patients sustained maxillofacial fractures and mild brain injury.

NEURON-SPECIFIC ENOLASE IN PATIENTS WITH ACUTE ISCHEMIC STROKE AND RELATED DEMENTIA

Neuron-specific enolase (NSE) levels of cerebrospinal fluid (CSF) were measured in 39 patients with ischemic stroke and 15 controls. There was a significant increase of CSF NSE in acute ischemic stroke patients as compared with the controls. The altered CSF NSE levels correlated well with the infarct size in CT scan. The CSF NSE levels were higher in 6-multiinfarct dementia (MID) patients who were diagnosed after 6-month follow-up than those in 22 non-MID patients of this series. Our research supports the view that CSF NSE can be a useful biochemical marker for brain ischemia. The importance of CSF NSE in the study of dementia related to ischemic stroke is worth further studies.

Choice of serum tumor markers in patients with small cell lung cancer:progastrin-releasing peptide,neuron-specific enolase,and carcinoembryonic antigen

Lung cancer is a leading cause of cancer-related deaths worldwide.It mainly consists of 2 histological types:small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC,including squamous cell carcinoma and adenocarcinoma).The present study aimed to assess the role of serum progastrin-releasing peptide(ProGRP),neuron-specific enolase(NSE),and carcinoembryonic antigen(CEA)and their combinations in the histological diagnosis of lung cancer(specially SCLC),which is of great importance for the initiation of treatment and prognostic implications.Serum ProGRP,NSE,and CEA were determined by the electrochemiluminescence immunoassay(ECLIA)in 66 patients with SCLC,73 with adenocarcinoma,44 with squamous cell carcinoma,45 with non-malignant pulmonary diseases,and 50 healthy controls.Receiver operating characteristic curves were constructed to compare the predictive ability of each biochemical marker and their combined detection models to discriminate among the patients with lung cancers of different histological groups,benign pulmonary diseases and healthy individuals.In the ECLIA detection system,ProGRP showed the sensitivity and specificity for SCLC diagnosis were 71.2%and 91.1%to 93.2%,respectively.Among the markers,the largest area under the ROCs was for ProGRP in discriminating SCLC from benign pulmonary diseases,squamous cell carcinoma and adenocarcinoma(0.815,0.859,and 0.835,respectively),which indicated that ProGRP was the most efficient marker for identifying SCLC.Besides,ProGRP and NSE exhibited almost equivalent diagnostic performance in discriminating SCLC from benign diseases.As for squamous cell carcinoma,we recommended proGRP,while for adenocarcinoma,the combination of proGRP and CEA was preferred.Remarkably,when ProGRP≤66pg/mL,CEA was of great value in diagnosing SCLC and adenocarcinoma.If CEA≤5ng/mL,the patient was at higher risk for SCLC,whereas the patient was more likely to be diagnosed with adenocarcinoma.Our study provided promising information about the diagnostic values of serum ProGRP,NSE,CEA in distinguishing SCLC from benign pulmonary diseases and NSCLC,which was of crucial clinical significance in the early diagnosis and therapy of SCLC.

Magnetic resonance imaging focused on the ferritin heavy chain 1 reporter gene detects neuronal differentiation in stem cells

The neuronal differentiation of mesenchymal stem cells offers a new strategy for the treatment of neurological disorders.Thus,there is a need to identify a noninvasive and sensitive in vivo imaging approach for real-time monitoring of transplanted stem cells.Our previous study confirmed that magnetic resonance imaging,with a focus on the ferritin heavy chain 1 reporter gene,could track the proliferation and differentiation of bone marrow mesenchymal stem cells that had been transduced with lentivirus carrying the ferritin heavy chain 1 reporter gene.However,we could not determine whether or when bone marrow mesenchymal stem cells had undergone neuronal differentiation based on changes in the magnetic resonance imaging signal.To solve this problem,we identified a neuron-specific enolase that can be differentially expressed before and after neuronal differentiation in stem cells.In this study,we successfully constructed a lentivirus carrying the neuron-specific enolase promoter and expressing the ferritin heavy chain 1 reporter gene;we used this lentivirus to transduce bone marrow mesenchymal stem cells.Cellular and animal studies showed that the neuron-specific enolase promoter effectively drove the expression of ferritin heavy chain 1 after neuronal differentiation of bone marrow mesenchymal stem cells;this led to intracellular accumulation of iron and corresponding changes in the magnetic resonance imaging signal.In summary,we established an innovative magnetic resonance imaging approach focused on the induction of reporter gene expression by a neuron-specific promoter.This imaging method can be used to noninvasively and sensitively detect neuronal differentiation in stem cells,which may be useful in stem cell-based therapies.

Research on the Correlation between NSE Level and Activities of Daily Living in Parkinson’s Disease

Objective: To establish a prediction model of activities of daily living (ADL) as an auxiliary evaluation scheme of hospitalized Parkinson’s disease patients. Methods: The hospitalization data of Parkinson’s disease in patients in the Department of Neurology, Affiliated Brain Hospital of Guangzhou Medical University were collected. Firstly the NSE values and each BI item were analyzed by Pearson correlation analysis. Secondly, The NSE, Age, Body weight and Education level related to the total score of Barthel index were obtained by correlation analysis. At last, a multiple linear regression model was established with NSE, Age, Body weight and Education level as independent variables and BI as dependent variables. Results: A total of 95 patients with PD were enrolled in this study, including 53 males (55.8%) and 42 females (44.2%). The effects of the four independent variables incorporated in the model on the total score of Barthel index were statistically significant, as well as the regression model (F = 9.531, P Conclusion: The prediction model established in this research can effectively predict the activities of daily living of Parkinson’s patients and can be used as an auxiliary evaluation scheme of the hospitalized PD patients.

颅脑创伤患者同时监测血清神经元特异性烯醇化酶及心肌酶的临床意义

目的探讨颅脑创伤患者血清神经元特异性烯醇化酶(NSE)与心肌酶的变化及两者的相关性。方法按GCS评分将91例颅脑创伤患者分成轻度组、中度组和重度组,分别测定受伤后第1天、第3天和第7天的血清NSE及心肌酶水平。结果 3组颅脑创伤患者伤后血清NSE和心肌酶均明显高于正常对照组,脑损伤程度越重,NSE和心肌酶水平就越高。此后NSE、心肌酶浓度虽然均呈下降趋势,但重度组NSE及心肌酶浓度仍明显高于正常对照组,差异有显著性。颅脑创伤后血清NSE水平和心肌酶水平呈正相关。结论同时监测颅脑创伤患者血清NSE及心肌酶,既可以动态了解患者的颅脑损伤程度,又能及时了解患者的心脏病变程度,及早发现心脏并发症,并给予积极的治疗。

颅脑损伤患者血清NSE的含量变化及临床意义

目的动态监测颅脑损伤患者血清神经元特异性烯醇化酶(NSE)的含量变化,并探讨NSE与颅脑损伤程度及其预后之间的关系。方法用酶联免疫测定法检测86例颅脑损伤患者的血清NSE含量,并分析其与颅脑损伤严重程度及患者预后的关系。结果颅脑损伤患者血清NSE水平明显高于对照组(P<0.05);重度颅脑损伤患者血清NSE水平又明显高于中、轻度颅脑损伤者(P<0.05);重度颅脑损伤预后不良者的血清NSE水平则明显高于预后良好者(P<0.05)。结论血清NSE水平与脑损害的严重程度呈正相关,可作为评估颅脑损伤预后的重要指标。

自身免疫性疾病患者血清抗白念珠菌烯醇化酶IgG型抗体的检测和分析

目的检测自身免疫性疾病患者血清中抗白念珠菌烯醇化酶(Eno)IgG型抗体表达情况。方法以重组白念珠菌Eno为包被抗原,建立ELISA检测方法并对反应条件优化,检测健康献血员对照组和自身免疫性疾病患者血清中抗白念珠菌Eno IgG型抗体。用Western blot法验证部分Eno抗体阳性血清的准确性。结果共检测自身免疫性疾病患者血清70份,其中抗白念珠菌Eno IgG型抗体阳性血清19份,总体阳性率为27.14%(19/70)。与对照组相比,自身免疫性疾病患者白念珠菌Eno IgG型抗体阳性率明显升高。其中,类风湿性关节炎患者白念珠菌Eno IgG型抗体阳性率为11.8%(2/17)、红斑狼疮患者阳性率为45.8%(11/24)。部分血清反应特异性得到Western blot验证。结论自身免疫性疾病患者血清抗白念珠菌Eno IgG型抗体阳性率较高,可能对白念珠菌Eno IgG型抗体应用于侵袭性念珠菌病诊断有干扰。

脑梗死患者血液和脑脊液NSE质量浓度测定及其临床意义的相关性研究

目的 观察急性期和恢复期脑梗死患者血液和脑脊液的神经元特异性烯醇化酶 (neuron-specific enolase,NSE)质量浓度变化 ,探讨其与神经功能缺损程度、脑梗死体积、颅内压以及患者年龄等方面的相关性。方法 该实验采用酶联免疫吸附法 (enzyme-linked immunosorbent assay,ELISA) ,检测观察组 (4 6例 )、对照组 (2 5例 )血液及脑脊液 NSE质量浓度 ,并应用 SPSS1 0 .0统计软件包进行统计学分析。结果 急性脑梗死 (acute cere-bralinfarction,ACI)患者血液和脑脊液 NSE质量浓度显著高于恢复期患者和对照组 (P <0 .0 1 ) ;ACI患者脑脊液 NSE质量浓度显著高于血液 (P <0 .0 1 ) ;血液和脑脊液 NSE质量浓度与梗死体积均呈显著正相关 (P <0 .0 1 ) ,与出院时神经功能缺损程度呈显著正相关 (P <0 .0 1 )。结论 脑脊液或血清中的 NSE质量浓度是脑组织破坏后较合适的生化标记物 ,有助于判断脑梗死患者梗死范围、监测病情变化及疗效观察。

病毒性脑炎患者血液和脑脊液NSE含量测定及其与临床的相关性研究

目的:为了观察病毒性脑炎急性期和恢复期患者血液和脑脊液的NSE含量变化,探讨其与异常脑电图和影像学低密度灶体积等方面的相关性。方法:将42例病毒性脑炎住院患者作为观察组,25例与观察组相匹配的阑尾或胆囊摘除手术病人以及健康体检者作为对照组;采用ELISA法,检测其血液及脑脊液NSE浓度;并应用SPSS13.0统计软件包进行统计学分析。结果:病毒性脑炎急性期患者血液和脑脊液NSE浓度显著高于恢复期患者和对照组(P<0.01);血液和脑脊液NSE浓度与低密度灶体积均呈显著正相关(rcsf=0.736,P<0.01;r血液=0.685,P<0.01);轻度、中度及重度异常脑电图患者脑脊液NSE浓度均高于血液(P<0.01);重度、中度异常脑电图患者血液及脑脊液NSE浓度均高于轻度(P<0.01)。结论:脑脊液或血清中的NSE浓度,反映了神经细胞和神经胶质细胞的损害程度,也是脑组织破坏后较合适的生化标记物。

双抗原夹心ELISA法检测抗念珠菌烯醇化酶抗体

目的建立检测抗念珠菌烯醇化酶(Eno)特异性抗体的双抗原夹心ELISA法,并进行临床应用评价。方法用基因工程制备的重组Eno作为包被抗原和酶标抗原,通过棋盘滴定法对双抗原夹心ELISA法的反应条件进行优化,对方法的敏感性、特异性和精密度进行考察。用双抗原夹心ELISA法测定291例住院患者(侵袭性念珠菌病114例,念珠菌定植82例,细菌感染患者95例)以及200名健康人血清,并与本实验室前期自建的间接ELISA法检测抗Eno抗体的结果进行比较。结果双抗原夹心ELISA法工作条件为:Eno抗原包被浓度为0.5μg/m L,酶标抗原1∶4 000稀释;封闭液为含50 g/L脱脂奶粉的PBS-T,待测血清稀释度为1∶100。患者血清检测结果显示,批内变异系数(CV)分别为6.8%、7.4%和5.9%;不同批次重复测定15次,其批间CV分别为10.1%、9.6%和12.4%。重组抗原对血清中相应抗体的阻断率为92.2%。通过ROC曲线确定cut off值吸光度(A)为0.209。检测侵袭性念珠菌病(invasive candidiasis,IC)的敏感性和特异性分别为81.6%(93/114)和94.4%(356/377),敏感性高于检测抗Eno抗体的间接ELISA法(81.6%vs 76.1%)。结论建立了双抗原夹心ELISA法检测抗念珠菌Eno特异性抗体,可提高IC的诊断率,具有临床应用价值。

急性脑梗死患者血清缺血修饰清蛋白和神经元特异性烯醇化酶变化的临床价值

目的 探讨急性脑梗死患者早期缺血修饰清蛋白和神经元特异性烯醇化酶（NSE）的临床意义.方法 采用终点法和电化学发光法分别对50例入院12 h内的急性脑梗死患者和50例体检健康者血清中的IMA和NSE进行测定.结果 急性脑梗死组血清中IMA的ACB值（56.7±6.10 U/ml）低于对照组（72.55±5.53 U/ml）,差异有统计学意义（t=-13.39,P＜0.01）;急性脑梗死组血清中NSE水平（23.03±6.91 ng/ml）高于对照组（10.85±2.61 ng/ml）,差异有统计学显著性意义（t=11.94,P＜0.01）.结论 IMA可以帮助判断脑组织缺血、缺氧程度,NSE可以帮助判断脑组织受损程度,两者联合检测可以作为急性脑梗死早期诊断、判断疾病缺血和损伤严重程度的指标.

神经元特异性烯醇化酶与脑梗死体积的相关性研究

目的 为了观察急性和恢复期脑梗死患者血液和脑脊液的神经元特异性烯醇化酶 (NSE)含量变化 ,探讨其与脑梗死体积以及患者年龄等方面的相关性。方法 采用酶联免疫吸附法 (ELISA) ,检测急性脑梗死 (ACI)患者(观察组 ) 4 6例 ,其他外科疾病患者及健康体检者 (对照组 ) 2 5例其血液及脑脊液NSE的含量 ;并应用SPSS 10 .0统计软件包进行统计学分析。结果 ACI患者血液和脑脊液NSE显著高于恢复期患者和对照组 (P <0 .0 1) ;ACI患者脑脊液NSE显著高于血液 (P <0 .0 1) ;血液和脑脊液NSE含量与梗死体积均呈显著正相关 (P <0 .0 1)。结论 脑脊液或血清中的NSE浓度 ,是脑组织破坏后较合适的生化标记物 ;有助于判断脑梗死病人梗死范围、监测病情变化及疗效观察。

弥漫性轴突损伤患者血清S100B和神经元特异性烯醇化酶的变化及意义

目的:探计弥漫性轴突损伤(diffuseaxonalinjury,DAI)患者血清S100B和神经元特异性烯醇化酶(neuron specifis enolase,NSE)浓度的变化及临床意义。方法:选择符合DAI诊断标准的脑外伤患者46例,对照组为同期受伤20例单纯头皮挫裂伤,无失血性休克患者.按照格拉斯哥预后评分Ⅰ～Ⅲ级(死亡,植物生存,严重残残)为预后不良组18例;Ⅳ-Ⅴ级(轻-中度致残和完全恢复)为预后良好组28例;于损后1h,3h,6h,12h,24h和48h采血检测血清中S100B和NSE浓度。结果:与对照组比较,DAI组S100B蛋白在伤后1h就明显增高(P<0.01),并持续升高至伤后6h,但预后良好组12～24h有所下降(P>0.05),48h下降有统计学意义(P<0.05);预后不良组S100B蛋白持续不下降。而NSE于伤后3h开始升高(P<0.05),6h达高峰(P<0.01),预后良好组12h下降(P<0.01),24h降至正常;预后不良组NSE持续不下降。结论:DAI患者血清S100B蛋白和NSE含量明显升高,联合监测血清S100B和NSE蛋白含量的变化不但能准确地反映出脑损害和程度而且可以判断DAI的预后。

手足口病患儿心肌酶等血清指标的分析

目的分析手足口病患儿心肌酶等血清指标的临床意义。方法选取2016年1月至2016年3月在昆明市妇幼保健院治疗的手足口病患儿179例,其中21例为危重型患儿,89例为重型患儿,69例为普通型患儿,同时选取健康儿童30例作为对照组,检测各组血清心肌酶、心肌肌钙蛋白I、神经元特异性烯醇化酶(NSE)和S-100#蛋白(S-100#)水平。结果危重型手足口病患儿血清乳酸脱氢酶(LDH)、α-羟丁酸酶(α-HBDH)、肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)分别为(402.13±34.29)IU/L、(312.37±61.92)IU/L、(154.20±17.82)IU/L和(27.83±9.04)IU/L,均高于重型和普通型患儿,差异均具有统计学意义(F值分别为4.581和4.294,5.394和7.933,8.104和9.373,10.014和11.294,均P<0.05),而CTnI为(0.11±0.02)IU/L,均低于重型和普通型患儿,差异均具有统计学意义(F值分别为7.693和9.032,均P<0.05);危重型和重型手足口病患儿NSE为(27.10±6.52)ng/mL和(19.43±6.10)ng/mL,S-100#分别为(730.14±42.19)pg/mL和(420.11±32.27)pg/mL,均高于普通型患儿和对照组,差异均具有统计学意义(F值分别为8.932和10.294,11.043和9.482,13.295和9.841,10.391和9.843,均P<0.05);危重型患儿NSE和S-100#水平高于重型患儿,差异均具有统计学意义(F值分别为9.032和12.194,均P<0.05);普通型和对照组NSE和S-100#差异比较无统计学意义(F值分别为1.432和1.043,均P>0.05)。结论血清心肌酶及心肌肌钙蛋白的检测能尽早发现手足口病患儿心肌损害,并及时治疗;NSE和S-100#蛋白在危重型和重型手足口病患儿中明显增高,与病情的严重程度有关。

新生儿溶血病患儿心肌酶谱、肌钙蛋白T及血清神经元特异性烯醇化酶检测的临床意义

目的通过对新生儿溶血病(HDN)患儿心肌酶谱、肌钙蛋白T(cTnT)及血清神经元特异性烯醇化酶(NSE)的检测,探讨心肌酶谱、cTnT、NSE在HDN引起心脏、神经系统功能改变中的临床意义。方法选择2016年6月~2017年6月我院经临床和实验室确诊的336例HDN患儿,根据总胆红素(TBIL)水平将HDN患儿分为A组(46例)、B组(66例)、C组(169例)、D组(55例),同时选取40例正常足月新生儿作为对照组。检测各组的TBIL、间接胆红素(IBIL)、心肌酶谱[天门冬酸氨基转换酶(AST)、磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)]、cTnT以及NSE水平;分析各指标与TBIL、IBIL之间的相关性。结果A、B、C、D组的TBIL、IBIL水平均高于对照组,差异有统计学意义(P<0.05);A、B、C、D组的TBIL、IBIL水平比较,差异有统计学意义(P<0.05);A、B、C、D组的AST、LDH、α-HBDH、NSE水平均高于对照组,差异有统计学意义(P<0.05);A、B、C、D组的AST、LDH、α-HBDH、NSE水平比较,差异无统计学意义(P>0.05);A、B组的CK、CK-MB水平均高于对照组,差异有统计学意义(P<0.05);C、D组的CK、cTnT水平与对照组及A组比较,差异有统计学意义(P<0.05);C组的CK-MB水平高于对照组,差异有统计学意义(P<0.05);D组的CK-MB水平低于A组和B组,差异有统计学意义(P<0.05)。AST、LDH、α-HBDH及NSE与TBIL、IBIL不相关(P>0.05);CK与TBIL、IBIL均成负相关(r=-0.18、-0.17,P<0.05);CK-MB与TBIL、IBIL均成负相关(r=-0.19、-0.20,P<0.05);cTnT与TBIL、IBIL均成正相关(r=0.15、0.16,P<0.05)。结论HDN患儿存在心肌酶谱、cTnT、NSE的改变,提示患儿可能存在心功能、神经系统受损,但与胆红素水平无明显线性相关性。