脑梗死患者血浆神经元特异性烯醇化酶变化及其临床意义  

Changes and Significance of Neuron-Specific Enolase Concentrations in Serum of Patients with Ischemic Cerebrovascular Diseases

作　　者：刘煜敏[1] 严国山 洪艳[3] 章军建[1] 

机构地区：[1]武汉大学中南医院神经科,武汉430071 [2]湖北省当阳市人民医院神经科,当阳443100 [3]武汉大学中南医院儿科,武汉430071

出　　处：《武汉大学学报（医学版）》2005年第4期520-522,共3页Medical Journal of Wuhan University

摘　　要：目的:观察脑梗死后血浆神经元特异性烯醇化酶(NSE)变化,评价其对脑梗死病情程度和转归判断的临床意义。方法:82例脑梗死病人发病后1d,2d,3d,1周,4周后的血浆NSE进行检测。同时测定头脑CT梗塞灶直径及神经功能缺损评分。另选50例健康体检者作为对照组。结果:卒中组当日血浆神经元特异性烯醇化酶浓度明显升高,较对照组差异有显著性意义(P<0.001)。该浓度的动态变化呈发病当日升高、次日降低、第3d又升高、1周后明显下降、4周后降到正常水平。第1d和3d的血浆神经元特异性烯醇化酶浓度与CT显示的梗塞灶直径显著正相关(r值分别为0.9011,0.7412,P<0.01);并与入院时的神经功能缺损评分显著正相关(r值分别为0.9103,0.8488;P<0.01),但与4周后神经功能缺损评分无显著相关性。结论:血浆神经元特异性烯醇化酶变化的测定可作为判断脑梗死病情轻重和预后的特异性指标。Objective: To observe the changes of Neuron-Specific Enolase (NSE) concentration in serum of patients with ischemic cerebrovascular diseases(ICD) and to evaluate its clinical significance. Methods: Plasma samples taken from 36 patients and 30 volunteers as control group were analyzed for NSE concentration using an enzyme immunoassay at the first, second, third, seventh day and after one month from onset. Meanwhile the diameter of cerebral infarction focus(DCIF) on computerized tomography(CT) and nerve function default grade(NFDG) were measured in the stroke group. Results: Stroke group showed a significantly higher level of plasma NSE concentration than control group did at the first day(P<0.001), then deceased at next day, increased again at the third day,obviously deceased after one week and continually decreased to normal levels after one month. There was close correlation between plasma NSE levels at the first and third day and DCIF(r=0.9011,0.7412; P<0.01) or NFDG at onset(r=0.910 3,0.848 8; P<0.01), but there was no correlation between NSE value and NFDG after the fourth week. Conclusion: The changes of plasma NSE values can be seen as a specific parameter for assessing the degree and the prognosis of ICD.

关 键 词：神经元特异性烯醇化酶 脑梗死 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]