血清神经元特异性烯醇化酶和二聚体对急性脑挫伤的诊断价值  

Diagnostic Value of Neuron-specific Enolase and D-Dimer on Acute Cerebral Contusion

作　　者：马涛[1] 张丽侠[2] 姚进[1] MA Tao;ZHANG Lixia;YAO Jin(Department of Neurosurgery,Bozhou People′s Hospital,Bozhou 236800,China;Department of Laboratory Medicine,Bozhou People′s Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院神经外科,安徽亳州236800 [2]亳州市人民医院检验科,安徽亳州236800

出　　处：《医学综述》2019年第18期3711-3714,3719,共5页Medical Recapitulate

摘　　要：目的 探究神经元特异性烯醇化酶(NSE)和D-二聚体对急性脑挫伤的诊断价值。方法 选择2017年1月至2018年12月亳州市人民医院收治的124例急性脑挫伤患者为研究对象,根据格拉斯哥昏迷评分(GCS)将患者分为轻型脑挫伤组(76例)和重型脑挫伤组(48例)。选择同期健康体检者30名作为正常对照组。比较各组受试者入院当天血清中NSE、D-二聚体水平。应用受试者工作特征曲线(ROC曲线)分析NSE、D-二聚体在脑挫伤病情中的诊断价值。结果 各组血清NSE、D-二聚体水平比较差异有统计学意义(P<0.01),轻型和重型脑挫伤组患者血清NSE、D-二聚体水平高于正常对照组(P<0.01),重型脑挫伤组患者高于轻型脑挫伤组(P<0.01)。血清NSE、D-二聚体水平在正常对照组和脑挫伤患者的曲线下面积(AUC)分别为0.967、0.910,差异均有统计学意义(P<0.01),NSE和D-二聚体对脑挫伤的最佳诊断临界值为23.77μg/L、0.29mg/L。血清NSE、D-二聚体水平在轻型和重型脑挫伤患者的AUC分别为0.820、0.870,差异均有统计学意义(P<0.01),NSE和D-二聚体对重型脑挫伤的最佳诊断临界值为43.17μg/L、0.79mg/L。结论 NSE、D-二聚体可作为急性脑挫伤的诊断参考指标,并能初步反映急性脑挫伤病情的严重程度。Objective To investigate the diagnostic value of neuron-specific enolase( NSE) and D-dimer on acute cerebral contusion. Methods A total of 124 patients with acute cerebral contusion admitted to Bozhou People’ s Hospital from Jan. 2017 to Dec. 2018 were included in the study. According to the Glasgow coma score( GCS),the patients were divided into a light cerebral contusion group and a heavy cerebral contusion group. Thirty healthy people for physical examination during the same period were included as a control group. Serum levels of NSE and D-dimer on admission day were compared. Receiver operating characteristic( ROC) curve was applied to analyze the diagnostic value of NSE and D-dimer in acute cerebral contusion. Results The serum NSE and D-dimer levels in the light and heavy cerebral contusion groups were significantly higher than those in the normal control group,with statistically significant differences( P < 0. 01). The serum levels of NSE and D-dimer in patients with severe cerebral contusion were significantly higher than those in patients with light cerebral contusion( P < 0. 01). The area under curve( AUC) of serum NSE and D-dimer in the control group and cerebral contusion patients were 0. 967 and 0. 910,respectively,with statistically significant difference( P < 0. 01);the optimal diagnostic thresholds of NSE and D-dimer for brain contusion were 23. 77 μg/L and 0. 29 mg/L. The AUC of serum NSE and D-dimer in the patients with mild and severe cerebral contusion were 0. 820 and 0. 870 respectively,with statistically significant difference( P < 0. 01);the optimal diagnostic thresholds of NSE and D-dimer for severe brain contusion were 43. 17 μg/L and 0. 79 mg/L. Conclusion NSE and D-dimer can be used as diagnostic indexes for acute cerebral contusion,and can initially reflect the severity.

关 键 词：急性脑挫伤 神经元特异性烯醇化酶 D-二聚体 

分 类 号：R651.1[医药卫生—外科学]