肝移植围手术期血浆S-100β和神经元特异性烯醇化酶的变化及与术后脑病的关系  

Changes in plamsa S-100β and neuron-specific enolase in peri-operative period of orthotopic liver transplan-tation and its relationship with encephalopathy after operation

作　　者：孙海云[1] 蔡珺[1] 庞红宇[1] 黑子清[1] 黎尚荣[1] 

机构地区：[1]中山大学附属第三医院麻醉科,广东广州510630

出　　处：《中国危重病急救医学》2009年第2期89-91,共3页Chinese Critical Care Medicine

基　　金：广东省科技计划项目（2006B36003019）

摘　　要：目的观察肝移植围手术期血浆S-100β和神经元特异性烯醇化酶（NSE）的变化，并分析其与术后脑病发生的关系。方法选择行同种异体原位肝移植手术患者30例；于麻醉后（T1）、术毕时（T2）及新肝24h（T3）经左侧颈内静脉导管取颈静脉球部血，采用酶联免疫吸附法（EusA）检测S-100β和NSE浓度；并根据术后是否发生脑病分为脑病组和非脑病组，分析S-10013和NSE浓度与脑病发生的相关性。结果30例患者S-3008浓度在T2时较T1时显著升高[（3．715±1．523）μg／L比（1．478±0．809）μg／L，P〈0．013，在T3时[（1．765±0．894）μg／L]下降接近T1水平；NSE浓度在T2时较T1时显著升高[（26．684±．973）μg／L比（14．012±4．612）μg／L，P〈0．01]，T3时（（18．105±7．345）μg／L3显著下降，但仍高于T1水平。脑病组（11例）和非脑病组（19例）患者S-100β、NSE浓度变化趋势与全体患者相同；脑病组T3时S-100β浓度高于非脑病组[（2．007±0．854）μg／L比（1．468±0．903）μg／L，P〈0．05]，且S-100β与脑病发生相关（r=0．385，P=0．039），T1、T2时S-100β浓度与脑病无相关关系；3个时间点NSE浓度与脑病发生均无相关关系。结论血浆S-100β和NSE水平在术毕时升高，提示在肝移植术中发生了脑损伤，但是监测S-100β和NSE均不能预测脑病的发生。Objective To observe the changes in plamsa S-100β and neuron-specific enolase （NSE） and to study their relationship with encephalopathy after orthotopic liver transplantation （OLT）. Methods Thirty patients without neurological disease undergoing OLT were studied. Plamsa S-100β and NSE were examined at three time points .. after induction of anesthesia （T1）, at the end of operation （T2） and 24 hours after reperfusion of the transplant （T3）. The difference of plamsa S-100β and NSE between encephalopathy group and non-encephalopathy group was analyzed. Results Eleven patients were complicated with encephalopathy after OLT. In 30 patients, S-100β at T2[（3. 715±1. 523）μg/L] was higher than that at T1 [（1. 478±0. 809） μg/L, P〈0. 01] 100β at T3[（1. 765±0. 894） μg/L] decreased to normal level （T1）. NSE at T2 [（26. 684±7. 973）μg/L] was higher than that at T1 [（14. 012±4. 612） μg/L, P〈0. 01]. At T3, the level of plamsa NSE [（18. 105±7. 345） μg/L] was decreased, but higher than that at T1. Plamsa 100β and NSE in encephalopathy group （11 cases） and non-encephalopathy group （19 cases） showed the same tendency of change as all of the patients. Plamsa 100β at T3 in encephalopathy group [（2. 007±0. 854）μg/L] was higher than that in non-encephalopathy group [（1. 468± 0. 903） μg/L, P〈0. 053, and it was correlated with the presence of encephalopathy （r= 0. 385, P=0. 039）, but not at T1 and T2. Plamsa NSE at three time points showed no relationship to the presence Of encephalopathy. Conclusion The increase in plamsa S-100β and NSE during OLT indicates the occurrence of damage to the brain. But plamsa S-100β and NSE cannot predict encephalopathy after OLT.

关 键 词：肝移植 血浆 S-100Β 神经元特异性烯醇化酶 术后脑病 

分 类 号：R686[医药卫生—骨科学]