NSE、S100B、MBP对蛛网膜下腔出血患者病情严重程度及预后的临床评估  

The value of NSE, S100B and MBP in evaluating the severity and prognosis in patients with subarachnoid hemorrhage

作　　者：丛海铭[1] 迟相林[1] 郭兆荣[2] 李振光[1] 周丽[1] 

机构地区：[1]潍坊医学院附属文登中心医院神经内科,264400 [2]潍坊医学院附属文登中心医院 妇产科,264400

出　　处：《中国医师进修杂志（内科版）》2008年第9期11-13,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨蛛网膜下腔出血（SAH）患者血清神经元特异性烯醇酶（NSE）、S100B、髓鞘碱性蛋白（MBP）水平对病情严重程度及预后评估的价值。方法对36例SAH患者（SAH组）在发病后72h内进行血清NSE、S100B、MBP水平检测，并与对照组（20例）进行比较，联合世界神经外科学会联合会（WFNS）分级和Glasgow结果评分（GOS）进行分析。结果SAH组患者血清NSE、S100B、MBP水平均显著高于对照组，而且不同病情严重程度患者及不同预后患者NSE、S100B、MBP水平比较差异有统计学意义。分别以发病后72h血清NSE水平25μg／L、S100B水平1．2μg／L、MBP水平10．0μg／L为临界标准，在评估病情严重程度方面，NSE特异度为71．43％，灵敏度为73．33％；S100B特异度为61．90％，灵敏度为86．62％；MBP特异度为66．67％，灵敏度为73．33％。在评估预后方面，NSE特异度为69．57％，灵敏度为61．54％；S100B特异度为60．87％，灵敏度为76．92％；MBP特异度为65．22％，灵敏度为69．23％。结论血清NSE、S100B、MBP水平对评估SAH患者病情严重程度及预后具有较高的特异度和灵敏度。Objective To research the significance of the levels of neuron-specific enolase（NSE）, S100B and myelin basic protein（MBP） in predicting the severity and prognosis in patients with subarachnoid hemorrhage （SAH）. Methods The serum levels of NSE, S100B and MBP were measured within 72 hours after the injury in 36 patients with SAH（SAH group ）, then the severity of illness and prognosis was evaluated by world federation of neurosurgical societies （WFNS） grade and Glasgow outcome scale （GOS） respectively. Twenty healthy persons were selected as controls（control group）. Results After the injury, the serum levels of NSE,S100B and MBP in SAH group increased significantly compared with those in control group. Moreover, there were significant difference in the serum levels of NSE, S100B and MBP among different groups in different severity of illness and prognosis. Assessed the severity and prognosis by serum levels of NSE 25 μ g/L, S100B 1.2 μg/L and MBP 10.0 μ g/L after 72 hours of SAH, the specificity of assessing the severity by NSE, S100B and MBP was 71.43%,61.90%, 66.67%, and the sensitivity was 73.33%,86.62% and 73.33%. At assessment of prognosis,the specificity of NSE, S100B, MBP was 69.57%, 60.87%,65.22%, and the sensitivity was 61.54%,76.92% and 69.23%. Conchltsion There are higher specificity and sensitivity in evaluating the severity of illness and prognosis in patients with SAH by serum levels of NSE, S100B andMBP.

关 键 词：磷酸丙酮酸水合酶 蛛网膜下腔出血 预后 疾病严重程度 S100B 髓鞘 碱性蛋白 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R195.1[医药卫生—临床医学]