神经元特异性烯醇化酶升高对继发性脑损伤病人预后的评估价值  

THE VALUE OF NEURON-SPECIFIC ENOLASE ELEVATION IN EVALUATING THE PROGNOSIS OF PATIENTS WITH SECONDARY BRAIN INJURY

作　　者：王美霞[1] 钟晓[1] 卓李圆 陈荣琳[1] 曹枫[1] WANG Mei-xia;ZHONG Xiao;ZHUO Li-yuan(Longgang Central Hospital of Shenzhen,Shenzhen 518116 China)

机构地区：[1]广东省深圳市龙岗中心医院

出　　处：《内蒙古医科大学学报》2019年第2期131-134,138,共5页Journal of Inner Mongolia Medical University

基　　金：深圳市龙岗区科技发展资金医疗卫生扶持类(2017040510493883)

摘　　要：目的:探讨急性期神经元特异性烯醇化酶(NSE)升高对ICU继发性脑损伤病人预后的评估价值。方法:分析我院ICU2017-04~2018-12期间收治的68例、无原发性脑部病变或脑外伤(且排除肿瘤)病人的临床资料,根据入科时病人血压及神志分为:A组-血压降低或神志变化者、42例,B组-术后复苏、无低血压或神志改变者、26例;选取2组病人入科后第2d7AM抽血化验的NSE并停镇静剂,10AM行BIS、GCS及APACHEⅡ评分并记录MAP,记录所有病人住ICU时间(d)及呼吸机使用时间(h),运用SPSS21.0软件独立样本t检验进行统计分析,探讨急性期NSE与2组病人住ICU及呼吸机使用时间等的关系。结果:2组病人Hb、HCT、NSE、MAP、BIS、GCS评分、APACHEⅡ评分、住ICU及呼吸机使用时间相比,具有显著性差异(P≤0.01);A组NSE比B组明显升高(P≤0.001),住ICU及呼吸机使用时间比B组明显延长(P=0.000),死亡9例,其中1例住ICU时间超过28d;B组NSE无明显变化,7d内均好转离开ICU.结论:急性期NSE升高,可作为评估ICU继发性脑损伤病人预后的检测指标。Objective:To evaluate the prognostic value of acute neuron-specific enolase(NSE)elevation in patients with secondary brain injury in ICU.Methods:The clinical data of 68 patientswithout primary brain lesions or traumatic brain injury(excluding tumors)admitted to ICU of our hospital from April 2017 to December 2018 were analyzed.According to the patients′ blood pressure and consciousness at the time of admission,the patients were divided into:group A-42 patients with decreased blood pressure or altered consciousness;group B-26 patients with postoperative resuscitation without hypotension and altered consciousness.The NSEof 7 am blood sampling on the second day after admission of the two groups of patients were selected,and the sedatives were stopped at the same time,10 amBISmonitoring,GCSandAPACHE Ⅱscores were made and recorded MAPat the time,the duration of ICU stay(days)and ventilator use(hours)of all patients were recorded,the datawere statistically analyzed using SPSS 21.0 software independent-samples T testto investigate the relationship between NSE of the acute stage and ICU stay and ventilator use time in 2 groups.Results:There were significant differences inHb,HCT,NSE,MAP,BIS,GCS scores,APACHEⅡ scores,duration of ICU stay andventilator use between the two groups( P ≤ 0.01 );NSE of group A significant increasecompared with group B( P ≤ 0.001 ),duration of ICU stayand ventilator use was significantly longer than that of group B( P = 0.000 ),9 cases of group A died and 1 cases in ICU more than 28 days;the patients of group B were improved whose NSE has no significant change,within 7 days leaving ICU.Conclusion:Elevated NSE in acute stage can be used as a prognostic indicator for patients with secondary brain injury in ICU.

关 键 词：急性期 神经元特异性烯醇化酶 继发性脑损伤 预后 

分 类 号：R446[医药卫生—诊断学]