急性缺血性脑卒中患者神经元特异性烯醇化酶、D-二聚体、同型半胱氨酸的变化规律  

Change Rules of Neuron-specific Enolase,D-dimer and Homocysteine in Patients with Acute Ischemic Stroke

作　　者：周景芬[1] 吴婷玉[1] 

机构地区：[1]武汉市第一医院老年病科,湖北武汉430022

出　　处：《华南国防医学杂志》2017年第10期665-667,F0004,共4页Military Medical Journal of South China

基　　金：武汉市卫生和计划生育委员会科研项目(WX16C38)

摘　　要：目的对急性缺血性脑卒中患者神经元特异性烯醇化酶(neuron-specific enolase,NSE)、D-二聚体(D-dimer,D-D)、同型半胱氨酸(homocysteine,Hcy)的变化规律进行分析探讨,为临床诊疗提供参考依据。方法选取2014-01/2016-12月间收治的急性缺血性脑卒中患者89例为观察组,取同期健康体检者90例为对照组,对两组受试者展开NSE、D-D、Hcy检测,观察组患者在发病后2、5、10 d分别检测,检测结果与对照组进行对比分析,对比观察组不同性别间患者第二天血清NSE、D-D、Hcy水平;将观察组患者按照入院后脑核磁共振成像(magnetic resonance imaging,MRI)检测结果,分成脑缺血损伤组织体积量值大、中、小3个亚组,对比3组患者发病第二天各项指标的检测结果。结果观察组发病2、5、10 d的NSE、D-D、Hcy检测结果均显著高于对照组,组间比较差异具有统计学意义(P<0.05);观察组患者NSE、D-D水平在发病第二天开始升高,第五天达到峰值,第十天开始降低;男性患者与女性患者D-D及Hcy检测结果男女比较差异具有统计学意义(P<0.05),NSE检测结果比较差异无统计学意义(P>0.05);观察组中3个亚组患者第二天NSE、D-D、Hcy检测结果显示,梗死面积越大,NSE、D-D检测结果越高,Hcy水平与梗死面积无明显变化。结论急性缺血性脑卒中患者梗死面积越大,NSE、D-D检测结果越高,在临床诊断工作中,可将其作为神经元损伤的定量判断依据,Hcy可作为一项辅助检查指标。Objective To analyze the changes of neuron-specific enolase（NSE）,D-dimer（DD）and homocysteine（Hcy）in patients with acute ischemic stroke,and provide the references for clinical diagnosis in the furture.MethodsEighty-nine patients with acute ischemic stroke from January 2014 to December 2016 were enrolled in this study as observation group.Ninety health people in the same period were selected as control group.The NSE,DD and Hcy levels of patients in two groups were detected,and the patients in observation group were tested at 2nd,5th and 10th day after onset respectively.Results in observation group were compared with those in control group.The patients of different sex in observation group contrasted the serum NSE,D-D and Hcy levels at 2nd day.The patients in observation group were divided into three subgroups of large,medium and small groups,according to the results of brain magnetic resonance imaging（MRI）after admission.The results of various indexes in three groups were compared.Results The serum NSE,DD and Hcy levels in the observation group were significantly higher than those in the control group at the 2nd,5th and 10th day（P0.05）.The serum NSE and DD levels in the observation group increased from the 2nd day,peaked at 5th day,and decreased from10 th day.There were significantly differences in D-D and Hcy levels between male and female patients（P0.05）,but no difference was found in serum NSE levels（P0.05）.The NSE,DD and Hcy results of three subgroups at the 2nd day showed that the more the infarct size,the higher the NSE and DD levels,but Hcy levels had no obvious change.Conclusion The infarct sizes in patients with acute ischemic stroke are more,the higher the NSE and DD levels.It can be used as a quantitative basis for neuronal injury in clinical diagnosis.Hcy can be used as an auxiliary index.

关 键 词：急性缺血性脑卒中 神经元特异性烯醇化酶 D-二聚体 同型半胱氨酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]