重型脑损伤患者血清TNF-α和NSE联检的临床意义  

Clinical significance of serum TNF-α and NSE in severe brain injury

作　　者：王孝芳[1] 李剑[1] 胡巨恒 宋光太[1] 郑博坤 

机构地区：[1]浙江省江山市人民医院,江山324100

出　　处：《浙江创伤外科》2015年第1期4-6,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨重型脑损伤患者血清TNF-α和NSE水平变化及其临床意义。方法选取本院2008年至2013年重型颅脑损伤患者89例（其中死亡11例）,应用电化学发光发检测血清TNF-α和NSE水平,分析其与临床病情变化和转归的关系。结果存活组和死亡组的TNF-α和NSE与对照组比较,P〈0.05;TNF-α和NSE死亡组升高较存活组明显,NSE在第5天起持续升高,第7天也无明显降低;TNF-α第1~2天就明显升高,两组第5~7天开始下降趋势;不同GCS患者比较：两组TNF-α总体比较,差异有统计学意义（P〈0.05）,NSE差异无统计学意义（P〉0.05）;不同预后组TNF-α和NSE变化比较：两组TNF-α总体比较,差异有统计学意义（P〈0.05）,NSE总体比较差异无统计学意义（P〉0.05）。结论血清TNF-α和NSE参与了重型脑损伤的病理生理过程,可能在继发性脑损伤中起重要作用,两个项目联检对于早期评估脑损伤的严重程度及判断预后有重要意义。Objective To investigate the change of serum TNF-a and NSE in severe brain injury patient and its clinical significance.Methods 89 cases（11 cases died） with severe brain injury were selected in our hospital from 2008 to 2013.The TNF-aand NSE level in serum were detected by chemiluminiscence method.The relationship between the change of TNF-a and NSE level and clinical condition was analyzed.Results TNF-a and NSE in death group were significantly increased than those in survival group.NSE continued to rise at fifth day,and did not reduce at seventh day.TNF-α increased significantly in 1-2 days and declined in 5~7 days.There was statistically significant difference between the two deferent GCS groups in TNF-a（P〈0.05）,and no significant difference in NSE（P〉0.05）.There was statistically significant difference between the two deferent prognosis groups in TNF-a（P〈0.05）,and no significant difference in NSE（P〈0.05）.Conlusion TNF-aand NSE were played an important role in the early assessment of severity and prognosis of brain injury.

关 键 词：重型脑损伤 肿瘤坏死因子-Α 神经元特异性烯醇化酶 

分 类 号：R651.1[医药卫生—外科学]