急性一氧化碳中毒患者血浆神经元特异性烯醇酶的动态变化及评估预后的意义  

Dynamic changes of plasma neuron-specific enolase level in the patients with acute carbon monoxide poisoning and its significance for prognosis

作　　者：姬新才[1] 郭伟[1] 时晔[1] 徐博[1] 刘丹萍[1] 孙励[1] 王菊兰[1] 

机构地区：[1]陕西省人民医院急诊内科,西安710068

出　　处：《中国急救医学》2007年第2期100-102,共3页Chinese Journal of Critical Care Medicine

基　　金：陕西省科技厅自然科学基金资助项目(No.2003C249)

摘　　要：目的探讨急性一氧化碳中毒患者血浆神经元特异性烯醇酶(neuron-specific enolase,NSE)的动态变化及评估预后的意义。方法收集急性一氧化碳中毒患者71例,分别于中毒后24h(71例)、第3天(69例)、第7天(68例)和第14天(68例)采集血标本,应用酶联免疫吸附法测定血浆NSE水平,检测结果与40例正常对照者比较,并探讨急性一氧化碳中毒患者血浆NSE水平的动态变化及其与临床神经功能改变的相关性。结果中毒后24h、第3天血浆NSE水平明显高于对照组(t值分别为10.29、6.64,均P<0.001),24h的变化较为显著;预后不良组血浆NSE水平在中毒后24h(11例)、第3天(9例)、第7天(8例)各时间点明显高于预后良好组(60例)(t值分别为5.86、3.78、2.16,均P<0.05)。存活的68例急性一氧化碳中毒患者中毒后第14天神经功能缺损评分减少值与24h、第3天血浆NSE水平呈负相关,相关系数分别为-0.40(P<0.001)和-0.36(P<0.01)。结论急性一氧化碳中毒患者早期血浆NSE水平明显升高,血浆NSE的动态变化可反映中毒的严重程度并对预后评估有重要意义。Objective To investigate the dynamic change of plasma neuron - specific enolase （NSE） level in the patients with acute carbon monoxide poisoning（ACMP） and its significance for prognosis. Methods 71 patients with ACMP were recruited into this study. The concentrations of NSE in the patients were measured by ELISA at 24 hours （71 cases）, 3 days 169 cases）, 7 days 168 cases） and 14 days （68 cases） after poisoning. The dynamic change of NSE and the relationships between plasma NSE level and neurological function impairment were explored. Results Compared with the control （40 cases） ,plasma NSE level in the patients with ACMP were significantly increased at 24 hours and 3 days, especially at 24 hours （t = 10. 29,6.64 ;P 〈 0.001）. The patients with bad prognosis had higher levels of plasma NSE than those with good prognosis at 24 hours, 3 days and 7 days（t =5.86,3.78,2. 16;P 〈 0. 05 ）. The decreased clinical neurological deficit scores negatively correlated with plasma NSE level at 24 hours and3 days （r= -0. 40, -0.36;P〈0.001,P 〈0.01）. Conclusions Plasma NSE level is increased at early stage of ACMP. Dynamic changes of plasma NSE level might reflect the degrees of acute carbon monoxide poisoning and the prognosis of patients with ACMP.

关 键 词：神经元特异性烯醇酶 一氧化碳中毒 预后 

分 类 号：R595.1[医药卫生—内科学]