亚急性1,2-二氯乙烷中毒患者神经元特异性烯醇化酶的检测  

Detection of neuron-specific enolase in patients with subacute 1, 2-dichloroethane poisoning

作　　者：杨志前[1] 李秀花[1] 范远玉[1] 陈育全[1] 张伊莉[1] 刘移民[1] Yang Zhiqian;Li Xiuhua;Fan Yuanyu;Chen Yuquan;Zhang Yili;Liu Yimin(Guangzhou 12th Municipal People's Hospital,Guangzhou 510620,China)

机构地区：[1]广州市第十二人民医院,510620

出　　处：《中华劳动卫生职业病杂志》2020年第7期530-533,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：广东省医学科学技术研究基金项目(A2016429);广州市高水平临床重点专科建设项目(穗卫函[2019]1555号)。

摘　　要：目的探讨亚急性1,2-二氯乙烷(DCE)中毒患者血清和脑脊液神经元特异性烯醇化酶(NSE)的变化。方法以2014年12月至2019年3月在广州市第十二人民医院住院的10例亚急性1,2-DCE中毒患者作为亚急性1,2-DCE中毒组,同期住院的34例典型急性中毒性脑病患者作为典型急性中毒性脑病组,40例健康体检者作为正常对照组。采用化学发光法检测亚急性1,2-DCE中毒组和典型急性中毒性脑病组患者发病期与好转期的血清NSE水平并进行统计学分析;检测亚急性1,2-DCE中毒组患者脑脊液NSE水平并与其血清NSE水平进行相关性分析;使用受试者工作特征(ROC)曲线分析NSE对亚急性1,2-DCE中毒和典型急性中毒性脑病的诊断效能。结果亚急性1,2-DCE中毒发病期组患者血清NSE水平与正常对照组和好转期组差异均无统计学意义(P>0.05),亚急性1,2-DCE中毒好转期组患者血清NSE水平低于正常对照组(P<0.01);亚急性1,2-DCE中毒发病期组患者血清NSE水平低于典型急性中毒性脑病发病期组(P<0.01)。亚急性1,2-DCE中毒组患者脑脊液NSE与血清NSE间无直线相关关系(r=-0.183,P=0.52);ROC曲线显示,血清NSE诊断亚急性1,2-DCE中毒和典型急性中毒性脑病的曲线下面积分别为0.661和0.726。结论亚急性1,2-DCE中毒患者血清NSE水平无明显变化。Objective To investigate the changes of neuron-specific enolase(NSE)in serum and cerebrospinal fluid of patients with subacute 1,2-dichloroethane(DCE)poisoning.Methods Ten patients with subacute 1,2-DCE poisoning hospitalized in Guangzhou 12th Municipal People's Hospital from December 2014 to March 2019 were taken as the subacute 1,2-DCE poisoning group,34 typical acute toxic encephalopathy patients hospitalized at the same time as typical acute toxic encephalopathy group,40 healthy physical examinees as normal control group.The levels of serum NSE in patients of subacute 1,2-DCE poisoning and typical acute toxic encephalopathy group during onset and improvement were detected by chemiluminescence method,and the results were analyzed statistically.The level of NSE in cerebrospinal fluid of subacute 1,2-DCE poisoning group was detected and analyzed its correlation with the level of NSE in serum.Using receiver operator characteristic(ROC)curve to analyze the diagnostic efficacy of NSE in subacute 1,2-DCE poisoning and typical acute toxic encephalopathy(area under curve,AUC).Results There was no significant difference between the serum NSE level of the patients with subacute 1,2-DCE poisoning in the onset group and the normal control group and the improvement group(P>0.05).The serum NSE level of subacute 1,2-DCE poisoning in the improvement group was lower than those in the normal control group(P<0.01).The serum NSE level of the subacute 1,2-DCE poisoning in the onset group was lower than those in the typical acute toxic encephalopathy in the onset group(P<0.01).There was no linear correlation between cerebrospinal fluid NSE and serum NSE in patients with subacute 1,2-DCE poisoning(r=-0.183,P=0.52).ROC curve showed that the AUC of serum NSE in diagnosing subacute 1,2-DCE poisoning and typical acute toxic encephalopathy were 0.661 and 0.726,respectively.Conclusion There is no significant change in serum NSE in patients with subacute 1,2-DCE poisoning.

关 键 词：二氯乙烷类 中毒 中毒性脑病 神经元特异性烯醇化酶 受试者操作特征曲线 

分 类 号：R595[医药卫生—内科学]