高原地区肺性脑病患者血清NSE和S-100β蛋白水平变化及与病情的关系  

Changes of serum neuron-specific enolase,S-100 β protein and its relationship with disease status in patients with pulmonary encephalopathy at high altitude area

作　　者：杨生岳[1] 冯恩志[1] 闫自强[1] 殷和[1] 张瑛[1] 贺巍[1] 祁玉曙[1] 陈宗茹[1] 

机构地区：[1]解放军第四医院兰州军区呼吸内科中心,青海西宁810007

出　　处：《中华肺部疾病杂志（电子版）》2012年第4期18-21,31,共5页Chinese Journal of Lung Diseases(Electronic Edition)

摘　　要：目的观察高原地区肺性脑病患者血清神经元特异性烯醇化酶(NSE)和S-100β蛋白(S-100β)水平的变化,探讨血清NSE和S-100β水平与病情的相关性。方法 对64例高原地区肺性脑病患者(A组)、228例肺心病患者(B组)采用以法检测血清NSE、S-100β含量,用血气分析仪测定动脉血氧分压(PaO2)和二氧化碳分压(PaCO2),并选择同海拔同年龄的50例健康人作对照(C组)。结果 A组和B组的PaCO2、血清NSE和S-100β水平显著高于C组,PaO2水平显著低于C组(均P<0.01);A组与B组之间比较,各项指标亦有显著性差异(均P<0.01)。在A组中,重型和中型患者的PaCO2、血清NSE和S-100β水平显著高于轻型患者,PaO2水平显著低于轻型患者(均P<0.01);重型与中型之间比较,各项指标亦有显著性差异(均P<0.01)。A组PaO2与血清NSE和S-100β呈显著负相关(r=-0.823、-0.792,均P<0.01),PaCO2与血清NSE和S-100β呈显著正相关(r=0.786、0.802,均P<0.01)。A组中,55例患者神经精神症状消失且病情稳定1周后,血清NSE、S-100β和PaCO2较治疗前显著降低,PaO2显著升高(均P<0.01),9例患者死亡前,血清NSE和S-100β较治疗前进一步升高(均P<0.01)。结论 血清NSE和S-100β的含量与肺性脑病患者病情严重程度密切相关,可作为判断其病情程度、估计预后的重要指标。Objective To observe the changes of serum neuron-specific enolase （ NSE）, S-100 beta protein （S-100β） in patients with pulmonary encephalopathy at high altitude, and therefore to investigate the relationship between serum NSE and S-100β and the disease status. Methods The levels of serum NSE, S-100β,partial pressure of artery blood 02 （PaO2 ） and partial pressure of artery blood CO2 （ PaCO2 ） were measured in 64 patients with pulmonary encephalopathy （group A） and 228 patients with chronic cor pulmonale （ group B ）, and 50 healthy volunteers served as controll （group C）. In group A, above parameteres were measured in 55 patients after one week disease status improvement and in 9 patients before death. Results Levels of serum NSE, S-100β and PaCO2 were significantly higher in group A and B than those in group C （ all P 〈 0.01 ） , and PaO2 was significantly lower in group A and B than this in group C （ all P 〈 O. 01 ）, there were significantly differences between the in group A and group B （ all P 〈 0. O1 ）. In group A, levels of serum NSE, S-100β and PaCO2 were significantly higher in severe type and moderate type than those in mild type （ all P 〈 0.01 ）, and PaO2 was significantly lower in severe type and moderate type than this in mild type （ all P 〈 0.01 ）, there were significantly differences between severe type and moderate type （ all P 〈 0.01 ）. The PaO2 was negatively correlated with serum NSE and S-100β（ r = -0.823. -0.792, all P 〈 0.01 ）, the PaCO2 was positively correlated with serum NSE and S-100β（r =0.786,0. 802,all P 〈0.01 ）in group A. Compared with before treatment, the levels of serum NSE, S-100β and PaCO2 were significantly reduced, and PaO2 was significantly elevated （all P 〈0.01 ） in 55 patients after one week disease status improvement, and levels of serum NSE, S-100β were further elevated （all P 〈0.01） in 9 patients before death in groups A. Conclision The levels of serum NSE and S-100β were closel

关 键 词：肺性脑病 神经元特异性烯醇化酶 S-100Β蛋白 高原地区 

分 类 号：R473.5[医药卫生—护理学] R563[医药卫生—临床医学]