微创清除颅内血肿患者血清h-FABP、NSE、S-100B水平变化及疗效观察  

The changes of serum levels of h-FABP,NSE,S-100B in patients with intracranial hematoma after minimally invasive surgical treatment and clinical observation on its therapeutic effect

作　　者：张东明[1] 杨文东[2] 

机构地区：[1]胜利石油管理局胜利医院神经外科,山东省东营市257055 [2]山东省利津县第二人民医院

出　　处：《河北医药》2012年第23期3540-3542,共3页Hebei Medical Journal

摘　　要：目的观察高血压脑出血患者行颅内血肿微创清除术前后血清心脏型脂肪酸结合蛋白(h-FABP)、神经元特异性烯醇化酶(NSE)、S-100B水平变化及临床疗效,探讨血清h-FABP、NSE、S-100B水平变化与病情及预后的关系。方法采用酶联免疫吸附(ELISA)法检测高血压脑出血患者(手术组74例和保守组45例)血清h-FABP、NSE、S-100B水平,并进行临床疗效对比分析。结果 (1)高血压脑出血患者血清h-FABP、NSE和S-100B水平均显著高于对照组(P<0.01);<60 ml和生存组患者血清h-FABP、NSE和S-100B水平均分别显著低于>60 ml和死亡组患者(P<0.01)。(2)h-FABP与NSE、S-100B呈正相关(r值分别为0.513和0.747,P<0.01),NSE与S-100B也呈正相关(r=0.492,P<0.01),三者之间相关性良好。(3)手术组无效和病死率显著降低(P<0.01),有效率显著提高(P<0.01);出血量<60 ml组有效率显著高于>60 ml组(P<0.01)。结论颅内血肿微创清除术治疗高血压脑出血临床疗效显著优于内科保守治疗,检测高血压脑出血患者微创术前后血清h-FABP、NSE和S-100B水平变化,可作为判断疾病严重程度、评价手术疗效和估计预后的重要参数。Objective To observe the changes of serum levels of heart fatty acid binding protein （h-FABP）, neuron specific enolase （NSE）, S-100B in patients with hypertensive cerebral hemorrhage before and after minimally invasive surgical treatment and clinical observation on its therapeutic effect, and to explore the correlation between the changes and patient＇ s prognosis. Methods The serum levels of h-FABP, NSE and S-100B were detected by ELISA in 74 patients （ surgical treatment group） and the other 45 patients （ conservative treatment group） ,and the therapeutic effects were observed and compared between the two groups. Results The serum levels of h-FABP, NSE and S-100B in patients with hypertensive cerebral hemorrhage were significantly higher than those in control group （ P 〈 0.01 ）. The serum levels of h-FABP, NSE and S-100B in patients with hemorrhage volume 〈 60 ml and patients in survival group were significantly lower than those of patients with hemorrhage volume 〉 60 ml and patients in death group （ P 〈 0. 01 ）. The levels of h-FABP were positively correlated with those of NSE,S-100,respectively （ P 〈0.01 ） ,so were between NSE and S-100B （ P 〈0.01 ）, there was a close correlation among them. The inefficiency and death rate in surgical treatment group were obviously decreased （ P 〈 0.01 ）, however, the effective rate was significantly increased （ P 〈 0.01 ）. The effective rate in patients with hemorrhage volume 〈 60 ml was significantly higher than that of patients with hemorrhage volume 〉 60 ml （ P 〈0.01 ）. Conclusion The therapeutic effect of intracranial haematoma minimally invasive removal on hypertensive cerebral hemorrhage is superior to that of conservative treatment of internal medicine. The detection of the serum levels of h-FABP, NSE, S-100B in patients with hypertensive cerebral hemorrhage before and after minimally invasive surgical treatment can be used as the important parameters for evaluating the severe degree of illness ,therap

关 键 词：颅内血肿微创清除术 高血压脑出血 心脏型脂肪酸结合蛋白 神经元特异性烯醇化酶 S-100B蛋白 动态变化 疗效评价 

分 类 号：R743.34[医药卫生—神经病学与精神病学]