急性脑梗塞患者血清NSE及S-100蛋白动态变化及意义  

Dynamic changes of serum NSE and S-100 protein in patients with acute cerebral infarction

作　　者：刘振华[1] 张清华[1] 崔元孝[1] 郝茂林[1] 郑茂永 潘宁[1] 王晓红[1] 张桂茹[1] 

机构地区：[1]山东大学附属省立医院神经内科,济南250021 [2]山东省莱芜市矫形康复医院神经内科,山东莱芜271100

出　　处：《山东大学学报（医学版）》2008年第8期751-755,共5页Journal of Shandong University:Health Sciences

基　　金：山东省卫生厅医药卫生科研项目(2003HZ103)

摘　　要：目的研究急性脑梗塞患者血清中神经元特异性烯醇化酶(NSE)及S-100含量与脑梗塞体积及预后的关系。方法58例急性脑梗塞患者,均于出现症状24 h内入组,50例健康对照者来自健康查体中心。在入院当时及第1、2、3、4、6、10天各留取血液标本1次,采用竞争性免疫放射分析测定技术测定NSE,用ELISA方法测定S-100。梗塞体积为第7天CT经Simes Somatom所提供的软件测得。神经功能恢复评定标准为修正的Rankin等级评分。结果NSE水平第2天达到高峰,从发病开始的NSE水平均与最终的脑梗塞体积存在正相关关系,在第2天相关关系最为密切(r=0.823,P<0.001)。S-100蛋白的高峰是在出现症状后的第3天。第3天S-100水平与梗塞体积(r=0.937,P<0.001)及Rankin等级评分(r=0.507,P<0.001)相关。结论血清中NSE及S-100蛋白含量的测定可能反映急性脑梗塞患者的脑梗塞体积,S-100蛋白含量还可以预测患者的预后。NSE及S-100检测可以作为急性脑梗塞病简单易行、价廉有效的判断病情及预后的指标。Objective To investigate the correlation of serum NSE and S-100 protein concentrations with infarct volume and prognosis in acute ischmic stroke. Methods 58 patients in Shandong Provincial Hospital with acute ischemic stroke presenting less than 24 hours after symptom onset were incorporated into the study. Serum NSE and S- 100 protein levels were detemfined on hos- pital admission and 1, 2, 3, 4, 6 and 10- days after symptom onset. Funcedonal outcome in 3 months after stroke （ modified Rankin scale score） and final infarct volume on day 7 were determined by means of standardized volumetry of brain images. Results The NSE concentration reached a maximum on day 2. The peak blood level of S-100 protein was found on day 3. The level of NSE on day 2 was well correlated with the infarct volume（ r = 0.823, P 〈 0. 001 ）, and the level of S-100 protein on day 3 was also well correlated with the infarct volume （ r = 0. 937, P 〈 0.001 ） and with the clinical outcome assessed with modified Rankin scale score （ r = 0. 507, P 〈 0. 001 ）. Conclusions NSE and S-100 protein in blood during acute stroke axe useful markers of infarct volume, and they may serve as easily accessible, inexpensive and valid prognostic markers in the future.

关 键 词：预后 脑梗塞 烯醇化酶 S-100蛋白 

分 类 号：R743[医药卫生—神经病学与精神病学]