脑梗死急性期血浆NSE、S-100b蛋白浓度变化与脑水肿关系的研究  

Cerebral Infarction Acute Phase Serum NSE and S-100b Protein Concentration Change with Findings of a Study of Cerebral Edema

作　　者：王文涛[1] 石秋艳[1] 王翠兰[1] 杨斌[1] 李艳玲[1] 

机构地区：[1]河北联合大学附属医院神经内科,河北唐山063000

出　　处：《中华中医药学刊》2015年第9期2249-2251,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：河北省卫生厅项目(zl20142079)

摘　　要：目的:观察急性脑梗死患者血清神经元特异性烯醇化酶(NSE)、S-100b蛋白的浓度变化,评价血清NSE、S-100b蛋白水平与急性脑梗死患者脑水肿严重程度的关系。方法:应用ELISA法对60例急性脑梗死患者入院后第2、3、5、7 d的血清NSE、S-100b蛋白水平进行动态检测,并使用开放源图像处理软件Osiri X计算脑梗死体积,同时采用BORN-BE无创脑水肿动态监护仪测定患侧大脑半球脑电阻抗扰动系数(CEI),并与60例健康人(对照组)作对照,对血清NSE与S-100b水平与脑梗死体积和急性脑梗死亚型的相关性进行分析。结果:(1)急性脑梗死组患者与对照组比,入院第2天的血清NSE与S-100b水平明显升高,入院第3天较第2天升高,第5天达到高峰,第7天又降低,差异有统计学意义(P<0.05);(2)急性脑梗死组患者血清NSE与S-100b水平变化与其患侧脑电阻抗扰动系数值的变化趋势相一致(P<0.05)。血清NSE与S-100b水平与脑水肿的严重程度呈正相关(P<0.05)。(3)不同梗死面积的急性脑梗死患者血清NSE与S-100b水平差异有统计学意义,梗死面积越大其含量水平越高。结论:血清NSE与S-100b水平可能与急性脑梗死患者脑水肿病情进展密切相关,对脑水肿的严重程度和病情判断有一定的临床指导价值,有望成为无创检测脑水肿的一项新指标。Objective： To observe the serum neuron specific enolization enzyme（NSE） and S-100 b protein concentration changes of patients with acute cerebral infarction and evaluate serum NSE and S-100 b protein levels and the relationship between the severity of patients with acute cerebral infarction cerebral edema. Methods： ELISA method was applied to 60 patients with acute cerebral infarction. 2,3,5,7 d after admission,serum NSE and S-100 b protein levels were observed by dynamic testing,and open source image processing software for Osiri X cerebral infarction volume calculation. At the same time,the BORN-BE noninvasive brain edema monitor dynamic measurement was used for the lateral hemisphere brain electrical impedance disturbance factor（CEI） and compared with 60 healthy people（control group）,the serum level of NSE and S-100 b subtype and the acute cerebral infarction cerebral infarction volume were made the correlation analysis. Results：（1） In acute cerebral infarction group and the control group on hospital 2 d,serum levels of NSE and S-100 b significantly increased and higher on hospital 3 d and reached the peak on 5 d and began to decrease on 7 d. The difference was statistically significant（P〈 0. 05）.（2） The acute cerebral infarction group patients＇ serum level changes of NSE and S-100 b were consistent with the change trend of brain electrical impedance disturbance factor value（P〈 0. 05）. Serum level of NSE and S-100 b was positively related with the severity of brain edema（P〈 0. 05）.（3） Different infarction areas of acute cerebral infarction patients serum level of NSE and S-100 b difference was statistically significant. The larger the infarction area,the higher levels. Conclusion： Serum level of NSE and S-100 b may be linked to brain edema progression in patients with acute cerebral infarction and has certain clinical value guidance for severity of cerebral edema and condition judgment,expecting to become a new noninvasive detection of brain edema.

关 键 词：脑梗死 脑水肿 神经元特异性烯醇化酶 S-100B蛋白 

分 类 号：R743[医药卫生—神经病学与精神病学]