慢性硬膜下血肿钻孔引流术前后血清血小板反应蛋白1/2、神经元特异性烯醇化酶、S-100β水平及其临床意义  

Levels of serum thrombospondin1/2,neuron-specific enolase and S-100β before and after trepanation and drainage in chronic subdural hematoma and their clinical significance

作　　者：薛亚飞 景芸芸[2] 张玉富 XUE Yafei;JING Yunyun;ZHANG Yufu(Department of Neurosurgery,Tangdu Hospital of Air Force Medical University,Xi′an,Shaanxi,710000;Department of Neurology,Xi′an Central Hospital,Xi′an,Shaanxi,710000)

机构地区：[1]空军军医大学唐都医院神经外科,陕西西安710000 [2]陕西省西安市中心医院神经内科,陕西西安710000

出　　处：《实用临床医药杂志》2020年第1期58-61,65,共5页Journal of Clinical Medicine in Practice

基　　金：陕西省科学技术研究发展计划项目(2017LJ-761-457)

摘　　要：目的探讨慢性硬膜下血肿(CSDH)患者钻孔引流术前后血清血小板反应蛋白1(TSP1)、血小板反应蛋白2(TSP2)、神经元特异性烯醇化酶(NSE)、S-100β水平及其临床意义。方法选取82例CSDH患者纳入CSDH组(根据脑损伤程度的不同分为轻度组、中度组),均行钻孔引流术,另选取同期健康体检者55名纳入对照组,采用酶联免疫吸附法测定血清TSP1、TSP2、NSE、S-100β水平,并分析钻孔引流术、脑损伤、术后复发与其表达水平的关系。结果CSDH组血清TSP1、TSP2、NSE、S-100β水平显著高于对照组(P<0.05);轻度组血清TSP1、TSP2、NSE、S-100β水平显著低于中度组(P<0.05);CSDH患者术后7 d的血清TSP1、TSP2、NSE、S-100β水平显著低于术前(P<0.05);术后复发者血清TSP1、TSP2、NSE、S-100β水平显著高于未复发者(P<0.05);CSDH患者钻孔引流术前后血清TSP1变化与血清NSE、S-100β变化均呈正相关(r=0.423、0.389,P<0.05),CSDH患者钻孔引流术前后血清TSP2变化与血清NSE、S-100β变化均呈正相关(r=0.418、0.392,P<0.05)。结论CSDH患者钻孔引流术后血清TSP1、TSP2、NSE、S-100β水平均降低,并与患者脑损伤程度、转归密切相关。Objective To explore the levels and clinical significance of serum thrombospondin 1(TSP1),thrombospondin 2(TSP2),neuron-specific enolase(NSE)and S-100βbefore and after trepanation and drainage in chronic subdural hematoma(CSDH).Methods A total of 82 patients with CSDH admitted to our hospital given trepanation and drainage were selected as CSDH group(further subdivided into mild group and moderate group according to the degree of brain injury),and another 55 healthy examiners in the same time period were selected as control group.Serum levels of TSP1,TSP2,NSE and S-100βwere determined by enzyme-linked immunosorbent assay.The relationships between trepanation and drainage,cerebral injury,postoperative recurrence and their expression levels were analyzed.Results The levels of serum TSP1,TSP2,NSE and S-100βin CSDH patients were significantly higher than those of controls(P<0.05).The levels of serum TSP1,TSP2,NSE and S-100βin mild group were significantly lower than those in moderate group(P<0.05).The levels of serum TSP1,TSP2,NSE and S-100βin CSDH patients at 7 d after surgery were significantly lower than those before surgery(P<0.05).The levels of serum TSP1,TSP2,NSE and S-100βin patients with postoperative recurrence were significantly higher than those without(P<0.05).The changes of serum TSP1 before and after trepanation and drainage in CSDH patients were positively correlated with the changes of serum NSE and S-100β(r=0.423,0.389,P<0.05),and the changes of serum TSP2 before and after trepanation and drainage in CSDH patients were positively correlated with changes of serum NSE and S-100β(r=0.418,0.392,P<0.05).Conclusion The levels of serum TSP1,TSP2,NSE and S-100βin CSDH patients are decreased after trepanation and drainage,and are closely related to the brain injury degree and outcomes.

关 键 词：慢性硬膜下血肿 钻孔引流术 血小板反应蛋白 神经元特异性烯醇化酶 S-100Β 

分 类 号：R651.1[医药卫生—外科学]