血清神经丝蛋白-3及特异性烯醇化酶在急性缺血性脑卒中的变化及意义  

Changes and Significance of Serum Neurofilament Protain-3 and Neurospecific Enolase in Patients with A- cute Ischemic Stroke

作　　者：张琛[1] 沈文娟[2] ZHANG Chen;SHEN Wen-juan(Xiaogan Central Hospital of Hubei Province,Xiaogan Hubei 432000)

机构地区：[1]湖北省孝感市中心医院急诊外科,湖北孝感432000 [2]湖北省孝感市中心医院重症医学科,湖北孝感432000

出　　处：《医学临床研究》2021年第2期189-191,共3页Journal of Clinical Research

基　　金：湖北省卫生和计划生育委员会科研项目(WJ2015MB015)。

摘　　要：【目的】观察急性缺血性脑卒中(AIS)患者血清神经特异性烯醇化酶(NSE)和神经丝蛋白-3(NFP-3)水平的变化及意义。【方法】选取65例AIS患者作为观察组,另选取同时期本院健康体检者40例作为对照组。观察组分别于入院24 h内和d3、d7、d14采集外周血样本,对照组于入院就诊当天采集外周血样本,两组均进行NSE和NFP-3水平的检测,比较两组患者在不同时间点的差异;绘制ROC曲线分析NSE和NFP以及二者联合对AIS患者的诊断价值。【结果】入院24 h内、d3和d7,观察组患者NSE和NFP-3水平较对照组明显升高(P>0.05);入院d14,观察组患者NSE和NFP-3水平与对照组比较差异无显著性(P>0.05);观察组患者NSE和NFP-3水平随着入院时间的变化呈先升高再降低的趋势。NSE、NFP-3以及二者联合预测AIS的AUC分别为0.874、0.926和0.967,敏感性分别为72.3%、76.9%和85.2%,特异性分别为90.3%、92.5%和95.6%。NSE和NFP-3对AIS的诊断最佳cut-off值分别为17.25 ng/mL和15.55 ng/mL。【结论】血清NSE和NFP-3水平在AIS患者体内明显升高,且随着疾病的好转,其水平呈下降趋势。NSE和NFP-3对AlS诊断均具较高的诊断价值,且NFP-3对AIS的诊断价值高于NSE,二者联合可明显提高AIS的诊断价值,提示NFP-3可用于AIS的诊断和病情评估。[Objective]To observe the changes and significance of serum neurospecific enolase(NSE)and neurofila­ment protein-3(NFP-3)levels in patients with acute ischemic stroke(AIS).[Methods]A total of 65 patients with AIS were selected as the observation group,and another 40 healthy people in the same period were selected as the control group.Peripheral blood samples were collected in the observation group within 24 hours and on D3,D7 and Dl4,and pe­ripheral blood samples were collected in the control group on the day of admission for detection of NSE and NFP-3 levels,and the differences between the two groups at different time points were compared;RCXT curve was drawn to analyze the diagnostic value of NSE and NFP and their combination in patients with AIS.[Results]The levels of NSE and NFP-3 in the observation group were significantly higher than those in the control group within 24 hours,3 and 7 days after admis­sion(P<0.05);there was no significant difference between the two groups on 14 days after admission(P>0.05);the levels of NSE and NFP-3 in the observation group increased first and then decreased with the change of admission time.The AUC of NSE.nfp-3 and their combination in predicting AIS were 0.874,0.926 and 0.967,respectively.The sensitiv­ity was 72.3%,76.9%and 85.2%,and the specificity was 90.3%,92.5% and 95.6%,respectively.The best cut-off values of NSE and NFP-3 were 17.25ng/mL and 15.55ng/mL,respectively.[Conclusion]Serum NSE and NFP-3 levels in AIS patients were significantly increased»and with the improvement of the disease,their levels showed a downward trend.NSE and NFP-3 have higher diagnostic value for AIS»and the diagnostic value of nfp-3 is higher than that of NSE.The combination of NSE and nfp-3 can significantly improve the diagnostic value of AIS,suggesting that NFP-3 can be used for the diagnosis and assessment of AIS.

关 键 词：脑缺血/诊断 磷酸丙酮酸水合酶/血液 中间丝蛋白质类/血液 

分 类 号：R743.3[医药卫生—神经病学与精神病学]