神经元特异性烯醇化酶预测恶性大脑中动脉供血区梗死的准确性  

The accuracy of neuron-specific enolase predicting malignant middle cerebral a^ery territory infarction

作　　者：李霞[1] 宿英英[1] 张运[1] 周王琳[1] 刘甜甜[1] 

机构地区：[1]首都医科大学宣武医院神经内科重症监护病房,北京100053

出　　处：《国际脑血管病杂志》2011年第2期90-94,共5页International Journal of Cerebrovascular Diseases

基　　金：首都医学发展科研基金联合攻关项目（2007-1043）

摘　　要：目的探讨血清神经元特异性烯醇化酶（neuron-specific enolase，NSE）预测恶性大脑中动脉供血区梗死（malignant middle cerebral artery infarction，mMCAI）的准确性。方法纳入40例发病24h内的急性大面积脑梗死患者，在发病后24、36和48h抽取血液样本，采用罗氏全自动电化学发光仪测定血清NSE浓度。mMCAI定义为临床出现脑疝征象且CT和（或）M砌显示占位效应。采用受试者工作特征曲线分析3个时间点血清NSE水平预测rnMCAI的准确性。结果16例患者发生mMCAI（40％）。发病后24h血清NSE水平预测mMCAI的准确性较差；36h血清NSE浓度预测mMCAI的特异性很高（96％），但敏感性较低（69％）；48h血清NSE浓度预测mMCAI的特异性（92％）和敏感性（88％）均很高。结论血清NSE浓度及其动态变化可预测mMCAI的发生，预测时间点以发病后36～48h为宜。Objective To investigate the accuracy of serum neuron-specific enolase （NSE） predicting malignant middle cerebral artery infarction （mMCAI）. Methods A total of 40 patients with acute massive cerebral infarction within 24 hours after symptom onset were recruited. Blood samples were collected at 24, 36 and 48 hours after symptom onset. Serum NSE concentration was determined by automatic electrochemiluminescence analyzer, mMCAI was defined as hernia signs in clinical practice, and CT/ MRI showed mass effect. The receiver operating characteristic curve was used to analyze the accuracy of serum NSE concentration in predicting mMCAI at 3 time points. Results Sixteen patients （40%） developed mMCAI. The serum NSE concentration for predicting the accuracy of mMCAI was poor at 24 hours after symptom onset; the serum NSE concentration for predicting the specificity of mMCAI was high （96%） at 36 hours after symptom onset, but the sensitivity was lower （69%）; the serum NSE concentration for predicting the specificity （92%） and sensitivity （88%） of mMCAI were high at 48 hours. Conclusions The serum NSE concentration and its dynamic changes may predict the occurrence of mMCAI, and the predicting time points are appropriate from 3648 hours after symptom onset.

关 键 词：神经元 磷酸丙酮酸水合酶 生物学标记 脑梗死 梗死 大脑中动脉 磁共振成像 试 验预期值 危险性评估 

分 类 号：R743.3[医药卫生—神经病学与精神病学]