NSE在颅脑手术前后患者血清中的动态变化及其与预后的关系  

Dynamic changes of NSE in patients before and after craniocerebral surgeries and its relation to prognosis of the patients

作　　者：曾湖[1] 谭源福[1] 刘梦姣[1] 黄宗海[1] 黄明权[1] 莫非[1] 王琛[1] 邵纯旭[1] 

机构地区：[1]广西医科大学第一附属医院神经外科,广西南宁530021

出　　处：《蛇志》2013年第2期112-114,120,共4页Journal of Snake

摘　　要：目的分析颅脑手术前后患者血清中神经元特异性烯醇化酶(NSE)的动态变化与治疗效果、预后的相关性。方法对我科2012年5月～2013年1月入院行择期手术的颅脑手术患者90例,按临床诊断分类分组进行手术。分别于术前1天,术后第1、3、7天抽取空腹外周静脉血,使用双抗体夹心ELISA法测定NSE的血清浓度,并与正常对照组比较。结果手术组中除面肌痉挛组外,术前血清中NSE含量均较对照组明显升高(P<0.01)。手术组术后第1、3天血清中NSE含量均较对照组明显升高(均P<0.01)。术后第7天,手术组中除面肌痉挛组外血清NSE含量较对照组明显升高(P<0.01)。各手术组血清NSE含量在术后均迅速上升,第1天达高峰,然后逐渐下降。根据预后评分,预后恶劣组血清NSE高于预后良好组(P<0.01)。行颅脑手术患者血清中NSE术前及术后第1、3、7天值与GOS评分呈负相关(r分别为-0.463、-0.682、-0.735、-0.748,均P<0.01)。结论动态监测血清NSE对不同颅脑手术患者手术前后进行病情评估、疗效观察及预后判断具有重要价值。Objective To analyze the relativity between dynamic change of NSE in serum and therapeutic effect as well as the prognosis of patients with craniocerebral operations before and after. Methods Ninety elective craniocerebral surgical patients from May 2012 to January 2013 were divided by clinical diagnosis. The fasting ve- nous blood was taken respectively at preoperative day, postoperative day 1,3 and 7 and tested by double antibody sandwich ELISA for content of NSE. Results Content of NSE of all the surgical groups but facial spasms group were significantly higher than of the control group at preoperative day and postoperative day 7, respectively （P~ 0.01）. Content of NSE of all the surgical groups were significantly higher than of the control group at postopera- tive day 1 and 3,respectively（P〈0.01）. The content of NSE in surgical groups were rising rapidly after surgery and reached the peak at postoperative day 1, then decreased gradually. Content of NSE in patients with different prognosis were significantly different （P〈0.01）. Content of NSE in patients with poor prognosis were significant- ly higher than of the favorable prognosis（P〈0.01）. Negative correlation existed between GOS score and the content of NSE in patients with craniocerebral operations respectively at preoperative day, postoperative day 1,3 and 7 （r= - 0. 463. - 0. 682. - 0. 735. - 0. 748, P〈 0. 01）. Conclusion NSE dynamic detection is valuable to the condition evaluation,efficacy observation and prognosis estimation of patients before and after craniocerebral sur- geries.

关 键 词：神经元特异性烯醇化酶 血清 脑损伤 颅脑手术 预后 

分 类 号：R651.1[医药卫生—外科学]