神经元特异性烯醇化酶和抗核抗体在神经系统副肿瘤综合征诊断中的意义  

Significance of neuron-specific enolase and antinuclear antibody in the diagnosis of Paraneoplastic neurologic syndrome

作　　者：陈健华[1] 陈琳[1] 崔丽英[1] 郭玉璞[1] 李晓光[1] 刘秀琴[1] 王建明[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院神经内科,北京100730

出　　处：《中风与神经疾病杂志》2008年第1期17-19,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的明确神经元特异性烯醇化酶(NSE)、抗核抗体(ANA)、血沉(ESR)、C反应蛋白(CRP)在神经系统副肿瘤综合征诊断中的意义。方法收集45份神经系统副肿瘤综合征患者血清标本,45例神经系统其它疾病患者作为对照。NSE采用放射免疫法检测,ANA以Hep-2细胞为底物的间接免疫荧光法检测,滴度在1∶80以上为阳性。ESR采用魏氏原理应用光电扫描法测定。CRP的测定采用免疫透射比浊度法测定。结果结果以χ±s表示。45例患者中,9例血清NSE升高(20.5%),全部均为肺癌。45例神经系统副肿瘤综合征患者中,27例血清ANA阳性(61.4%),平均滴度1∶640。29例副肿瘤性周围神经病患者中14例(48.3%)血清ANA阳性,平均滴度1∶320。而在对照组血清ANA滴度全部均在1∶40以下。结论ESR、CRP在副肿瘤综合征患者体内也可以升高,但缺乏特异性。NSE对神经系统副肿瘤诊断无明确意义,但对于ANA阳性的患者,在除外胶原血管病的前提下,应警惕有无神经系统副肿瘤综合征。Objective To identify the significance of neuron-specific enolase （NSE） and antinuclear antibody （ ANA）, erythrocyte sedimentation rate （ ESR）, C-reactive protein （CRP） in the diagnosis of Paraneoplastic neurologic syndrome. Methods There were forty-five sera from the patients of Paraneoplastic neurologic syndrome and other neurologic system diseases as controls respectively. NSE was detected by the mean of radioimmunity ,ANA was detected by indirect immunofluorenscence, ESR was detected by photo-electric scanning, and CRP was detected by turbidimetric immunoassay. Results There were nine patients in the Paraneoplastic neurologic syndrome group whose NSE were elevated. All of these patients had small cell lung cancer. There were twenty-seven patients in the Paraneoplastic neurologic syndrome groups whose ANA were positive. The mean titer of ANA was 1：640. There were fourteen patients in the twenty-nine Paraneopla- sytic Peripheral neuropathy patients groups whose ANA were positive. The mean titer of ANA was 1：320. While,in the control groups, ANA were all negative. Conclusions ESR and CRP can elevated in Paraneoplastic neurologic syndrome patients without specificance. There is no significance of NSE in the diagnosis of Paraneoplastic neurologic syndrome. But for those whose ANA are positive, Paraneoplastic neurologic syndrome should be thought about when there is no evidence of connective tissue disease.

关 键 词：神经元特异性烯醇化酶 抗核抗体 血沉 C反应蛋白 神经系统副肿瘤综合征 

分 类 号：R747.9[医药卫生—神经病学与精神病学]