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作 者:魏风[1] 陈俭[1] 黄勤[2] 朱晟[1] 卢科[1] 谢华[1] 张英鹏[1]
机构地区:[1]广西医科大学临床第三附属医院神经外科,南宁530031 [2]广西医科大学实验中心,南宁530022
出 处:《中国微侵袭神经外科杂志》2011年第11期511-513,共3页Chinese Journal of Minimally Invasive Neurosurgery
基 金:广西卫生厅立项课题(编号:Z2009003);南宁市科学技术局立项课题(编号:200902081C-1)
摘 要:目的探讨弥漫性轴索损伤(DAI)病人脑脊液神经元特异性烯醇化酶(NSE)的动态变化及其临床意义。方法分别用放射免疫测定法检测76例DAI病人(实验组)和15例无神经系统疾病者(对照组)的脑脊液NSE含量。实验组根据入院时GCS评分分为轻型组23例、中型组27例和重型组26例。分别于颅脑损伤后12 h、1 d、3 d、7 d、14 d采集脑脊液标本,分析NSE水平与颅脑损伤严重程度及预后的关系。结果与对照组比较,轻型组伤后12 h~3 d、中型组伤后12h~7d、重型组伤后12 h~14 d的NSE水平均明显增高(P<0.05);重型组各时间点NSE水平明显高于轻型组和中型组(P<0.01)。随访3个月,轻型组、中型组和重型组预后不良率分别为0%、14.81%及73.08%。结论脑脊液NSE水平可作为判断DAI损伤程度及预后的指标,并指导选择和调整治疗措施。Objective To investigate the dynamic change and clinical significance of neuron-specific enolase (NSE) level in the cerebrospinal fluid (CSF) in patients with diffuse axonal injury (DAI). Methods The NSE levels in CSF were detected by radioimmunoassay in 76 patients with DA1 (experimental group) and 15 patients without nervous system disease (control group) respectively. According to the GCS scores on admission, the patients in experimental group were divided into minor injury group (n=23), moderate injury group (n=27) and severe injury group (n=26). The CSF samples were collected at 12 hours, 1, 3, 7 and 14 days after head injury. The relationships between the NSE level and both the severity of DAI and prognosis were analyzed. Results Compared with the control group, the NSE levels in CSF were significantly increased at 12 hours to 3 days after DAI in minor injury group, 12 hours to 7 days after DAI in moderate injury group and 12 hours to 14 days after DAI in sever injury group (P〈0.05). The NSE levels in every time point were obviously higher in the severe injury group than in the minor or moderate injury group (P〈 0.01). During a follow-up period of 3 months, the rate of poor prognosis was 0%, 14.81% and 73.08% in minor, moderate and severe injury group respectively. Conclusions The NSE levels in CSF can be regard as an index for judging the injury severity and prognosis of DAI, and can be used to guide the option and adjustment of therapeutic approaches for patients with DAI.
关 键 词:颅脑损伤 弥漫性轴索损伤 神经元特异性烯醇化酶:脑脊液
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