短暂性脑缺血发作患者血清神经元特异性烯醇酶水平的动态变化(英文)  

Dynamic changes of serum neuron-specific enolase level in patients with transient brain ischemic attack

作　　者：马驰骋[1] 刘爱军[1] 孙海玲[1] 张金华[1] 孙涛[1] 

机构地区：[1]济南市第四人民医院,山东省济南市250031

出　　处：《中国临床康复》2005年第37期154-155,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:神经元特异性烯醇酶是γ型同工酶特异地存在于神经元和神经内分泌细胞的胞浆内,是神经元损伤较敏感的标志物。目的:观察短暂性脑缺血发作患者血清神经元特异性烯醇酶的变化,探讨其与疾病的神经损伤程度的关系。设计:病例-对照观察。单位:济南市第四人民医院神经内科。对象:选择2002-03/2004-05在济南市第四人民医院神经内科入院的短暂性脑缺血发作患者29例(均为起病后6h的急诊观察患者)。男18例,女11例。平均(60.36±11.67)岁。根据神经功能缺失症状持续时间分为两组:短症状组(≤6h)19例,长症状组(>6h)10例。同期选取健康体检者为对照组,共25人。男15人,女10人。平均(62.34±9.65)岁。方法:对照组只取1次空腹肘静脉血1mL,短暂性脑缺血组在入院即时,第2,3,4,5天分别采空腹肘静脉血1mL。采用罗氏Elecsys2010免疫测定分析仪检测血清神经元特异性烯醇酶。用神经功能缺损程度量表(基本痊愈为评分减少90%-100%;显著进步为评分减少46%-89%;进步为评分减少18%-45%;无效为评分减少17%以下或病情恶化)评定患者的神经损伤程度。主要观察指标:观察患者血清神经元特异性烯醇酶的每天变化情况。结果:检测者54例均进入结果分析。①神经元特异性烯醇酶浓度的比较:短暂性脑缺血发作组明显高于对照组[(23.53±12.35,14.29±6.83)μg/L,t=2.678,P<0.01]。②急性期内神经元特异性烯醇酶变化曲线:早期增高,次日达高峰,后趋向逐渐下降,四五天基本恢复正常。③神经功能缺失症状持续时间不同的两组血清神经元特异性烯醇酶:短症状组明显高于对照组[(19.24±8.95,14.29±6.83)μg/L,t=1.893,P<0.05],长症状组高于对照组[(28.87±13.15,14.29±6.83)μg/L,t=4.367,P<0.001]。④神经元特异性烯醇酶值的大小与神经功能缺损时间呈正相关(r=0.815,P<0.01)。结论:短暂性脑缺血发作患者短期内血清神经元特异性烯醇�BACKGROUND： Neuron-specific enolase, γ type isoenzyme that is specially present in the cytoplasm of neurons and neuroendocrine cells, is considered as a sensitive predictor for neuronal damage. OBJECTIVE： To observe the changes of serum neuron-specific enolase in patients with transient brain ischemic attack, so as to explore its relationship with the degree of neuronal damage. DESIGN： Case-control observation. SETTING： Department of Neurology, Jinan No. 4 People＇s Hospital. PARTICIPANTS： A total of 29 patients who were hospitalized in the Department of Neurology, Jinan No. 4 People＇s Hospital, due to transient brain ischemic attack （all called for emergent medical treatment within the onset of 6 hours） between March 2002 and May 2004 were enrolled in this study. There were 18 males and 11 females with the average age of （60.36±11.67） years. According to the duration of neural functional deficits, all subjects were divided into two groups, namely, transient-symptom group （≤ 6 hours） of 19 cases and lasting-symptom group （〉 6 hours） of 10 cases. At the same time, 25 healthy controls, 15 males and 10 females with the average age of （62.34±9.65） years, iere selected from those who came for routine health examination. METHODS： Fasting elbow venous blood of 1 mL was collected only once from the subjects in control group; the same amount of blood was collected from the patients in transient ischemic attack group immediately after hospitalization, and at days 2, 3, 4 and 5. Roche Elecsys 2010 automatic analyzer was used to detect serum neuron-specific enolase. Neuronal damage was assessed with neurological deficit scale （defined as practical recovery if scores were reduced by 90%-100%; remarkable improvement if scores were reduced by 46%-89%; improvement if scores were reduced by 18%- 45%; ineffective if scores were reduced by less than 17% or even the disease aggravated）. MAIN OUTCOME MEASURES： The daily changes of serum neuronspecific enolase. RESULTS： All the 54 subj

关 键 词：脑缺血发作 短暂性 血清学 神经元 

分 类 号：R743[医药卫生—神经病学与精神病学]