55例多梗塞性痴呆患者脑脊液TNF和NSE的测定及其临床意义  

Clinical significance and changes of tumor necrosis factor and neuron-specific enolase in cerebrospinal fluid of patient with multi-infarct dementia

作　　者：王景周[1] 高东[1] 李强[1] 高唱[1] 张莉莉[1] 

机构地区：[1]第三军医大学附属大坪医院野战外科研究所神经内科,重庆400042

出　　处：《第三军医大学学报》2001年第10期1237-1239,共3页Journal of Third Military Medical University

基　　金：重庆市科委科研基金资助项目 ( 1 999-2 0 0 1 )

摘　　要：目的　研究多梗塞性痴呆 (MID)患者脑脊液 (CSF)中肿瘤坏死因子 (TNF α)和神经元特异性烯醇酶 (NSE)的含量变化及临床意义。方法　采用放射免疫分析法对 55例MID患者CSF中TNF α进行测定 ;采用双抗体夹心ELISA法测定NSE浓度。并与同期住院的 72例脑梗塞 (CI)患者及 3 2例神经系统功能性疾病 (Control)患者进行比较。患者的智能水平测定采用简易智能量表(MMSE) ,并参考Hachinski缺血评分及DSM Ⅳ诊断标准。结果　MID急性发作期及CI急性期CSF中TNF α、NSE的浓度均非常显著高于Control组 (P <0 .0 1 ) ;MID稳定期及CI恢复期CSF中TNF α的浓度显著高于Control组 (P <0 .0 5) ;MID稳定期CSF中TNF α的浓度同CI恢复期组差异不显著 (P >0 .0 5)。而MID稳定期CSF中NSE浓度低于Control组和CI恢复期组 (P <0 .0 5)。各组CSF中TNF α、NSE的浓度与MMSE评分无显著相关性 (P >0 .0 5)。结论　MID急性发作期与稳定期患者CSF中TNF α、NSE含量呈非一致性变化。MID患者CSF中TNF α、NSE含量变化可能客观地反映患者脑细胞缺血缺氧性损害。但TNF α、NSE含量变化不能直接反应MID患者的智能状态。Objective To study the changes of tumor necrosis factor alpha (TNF α) and neuron specific enolase (NSE) in cerebrospinal fluid (CSF) and its clinical significance in patients with multi infarct dementia (MID). Methods The concentration of TNF α in CSF was determined by RIA ,and the concentration of NSE in CSF was determined by ELISA in 55 patients with MID and compared with 72 patients with cerebral infarction (CI) and 32 patients with functional diseases of nervous system(Control). Mini mental state examination (MMSE)?Hachinski Ischemia Score and DSM IV diagnosis standard were used to examine the intellectual level of patients. Results TNF α or NSE concentration in CSF of patients with MID acute episode group and CI acute phase group was significantly higher than that in control group ( P <0.01). TNF α concentration in MID stationary phase group or CI recovery phase group was higher than that in control group( P <0.05). No significant difference was found in TNF α concentration in CSF between MID stationary phase group and CI recovery phase group ( P >0.05). NSE concentration in MID stationary phase group was lower than that in control group( P <0.05). There was no significant correlation between MMSE scores and TNF α or MMSE scores and NSE concentration in CSF ( P >0.05). Conclusion TNF α, NSE concentration in CSF of all patients with MID did not present concordant changes at all. The changes of TNF α, NSE concentrations in CSF could reflect the brain cell ischemic lesion objectively in patients with MID. However, the changes of TNF α, NSE could not directly indicate the intellectual status of MID patients; for it was not a kind of intellectual factor.

关 键 词：多梗塞性痴呆 肿瘤坏死因子α 神经元特异性烯醇酶 

分 类 号：R749.16[医药卫生—神经病学与精神病学]