血液净化对脓毒性脑病神经元特异性烯醇化酶的影响  

Effect of Blood Purification on Septic Encephalopathy Neuron- specific Enolase

作　　者：安媛[1] 王义[1] 王娟[1] 邓阳彬[1] 楚建平[1] 

机构地区：[1]西安市儿童医院重症医学科,西安陕西710003

出　　处：《昆明医科大学学报》2016年第2期76-79,共4页Journal of Kunming Medical University

基　　金：西安市科技计划项目(SF1019[4])

摘　　要：目的探讨血液净化对脓毒性脑病(SAE)神经元特异性烯醇化酶(NSE)的影响,为临床提供早期诊断脓毒性脑病的方法及治疗SAE的手段.方法选取西安市儿童医院收治的150例脓毒性脑病患儿,随机分为观察组与对照组,每组75例,对照组患儿接受原发病及重要器官支持等综合治疗,观察组在对照组治疗基础上接受血液净化治疗.2组患儿于确诊后24 h内及治疗7 d后留取脑脊液(CSF)进行常规、生化(GUL、LDH、LA)及NSE检查,同时于患儿确诊后1、2、3、5、7 d分别采血2 m L进行NSE检测.结果 2组患者确诊后CSF检查:常规无异常,生化检测结果显示,GUL显著低于正常儿(P<0.05),LDH、LA显著高于正常小儿(P<0.05),观察组治疗7 d后,GUL、LDH、LA指标与正常小儿比较(P>0.05),对照组治疗7d后GUL、LDH、LA恢复情况显著低于观察组;脑脊液及外周血NSE水平对比结果显示,治疗前3 d 2组患儿的NSE水平对比无显著差异(P>0.05),治疗5 d、7 d时观察组患儿的NSE水平显著低于对照组,差异有统计学意义(P<0.05).结论脓毒性脑病患儿血及脑脊液中NSE显著升高,血液净化治疗能加速降低NSE浓度,改善脑脊液中GUL、LDH、LA指标,在脓毒性脑病的治疗中起着重要作用,提高脓毒性脑病患儿救治率,降低致残率及死亡率.Objective To investigate the application of blood purification of septic encephalopathy（ SAE） of neuron specific enolase（ NSE） influence, for clinicians to provide an early diagnosis of septic encephalopathy and treatment methods for the SAE means, improve the rate of septic encephalopathy treatment to reduce morbidity and mortality.Methods 150 cases of septic encephalopathy admitted in our hospital were randomly divided into observation group and control group, 75 cases in each group.Patients in the control group received primary disease and vital organ support and comprehensive treatment, patients in the observation group received additional blood purification treatment.The cerebrospinal fluid（ CSF） samples of two groups of children diagnosed after 24 hours and 7 days after treatment were collected for routine, biochemical（ Gul, LDH, LA） and neuron specific enolase（ NSE） check, the blood samples 1, 2, 3, 5, 7 days after diagnosis were collected for detection of NSE.Results No abnormal biochemical test results were found, Gul was significantly lower than that of normal children（ P〈0.05）, lactate dehydrogenase（ LDH） and La was significantly higher than that of normal children（ P〈0.05）, 7 d after the treatment, Gul, LDH, La index in the observation group was similar to normal children（ P〈0.05）, in control group, 7 days after treatment, Gul, LDH, La recovery was significantly lower than those in the observation group; cerebrospinal fluid and peripheral blood NSE levels were compared, and the result showed, 3days before treatment, the patients, NSE levels had no significant difference between two groups, 5 d, 7 d after treatment the NSE level in observation group was significantly lower than that of the control group, the difference wasstatistically significant（ P〈0.05）.Conclusion Children with septic encephalopathy have higher blood and CSF NSE increased significantly, blood purification treatment can accelerate the reduction of NSE concentration and improve the cereb

关 键 词：血液净化 脓毒性脑病 神经元特异性烯醇化酶 

分 类 号：R749.1[医药卫生—神经病学与精神病学]