轻中度颅脑损伤患者认知功能障碍与血清神经特异性烯醇化酶水平相关性  

Explore the Relationship Between Cognitive Dysfunction and Serum Neuron Specific Enolase Levels in Patients with Mild and Moderate Craniocerebral Injury

作　　者：艾克拜尔·哈里克[1] 秦虎[2] 童凌霄 木塔力甫·努热合买提[1] 宋海·别德勒汗 闫宝锋 AIKEBAIER Halike;QIN Hu;TONG Lingxiao(Department of Neurosurgery,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi City,Xinjiang 830063)

机构地区：[1]新疆医科大学第二附属医院神经外科,新疆乌鲁木齐市830063 [2]新疆医科大学第一附属医院神经外科

出　　处：《医学理论与实践》2024年第19期3259-3262,3272,共5页The Journal of Medical Theory and Practice

基　　金：新疆神经系统疾病研究重点实验室开放课题(XJDX1711-2114)。

摘　　要：目的:探讨轻中度颅脑损伤患者认知功能障碍与神经特异性烯醇化酶(NSE)水平的相关性。方法:选择2017年9月—2020年9月收治的轻中度颅脑损伤患者82例,入院时检测患者血清NSE,待患者病情平稳后采用中文版蒙特利尔认知评估量表(MoCA)评估认知功能,根据是否出现认知功能障碍分正常组和障碍组。单因素分析比较两组患者基本临床资料差异;进一步对比正常组和障碍组患者不同类型及不同部位颅脑损伤血清NSE的变化差异;相关性分析入院时患者血清NSE与患者MoCA评分相关性;多重线性回归分析探讨颅脑损伤后认知功能障碍影响因素。结果:障碍组硬膜下出血者血清NSE、蛛网膜下腔出血者血清NSE、脑挫裂伤者血清NSE,损伤部位额叶者血清NSE、颞叶者血清NSE、顶叶者血清NSE、枕叶者血清NSE,均高于正常组硬膜下出血者,差异有统计学意义(P<0.05),其中脑挫裂伤、额叶损伤患者入院时血清NSE含量最高,差异最明显;出院后1年随访45例患者MoCA评分28(24.50,30.00)分,Spearman相关性分析提示与45例患者入院时血清NSE(15.26,2.85)ng/mL之间存在负相关性(P<0.01);多重线性回归显示,根据吸烟史、损伤类型、损伤类别、头颅CT出血量和血清NSE含量预测患者认知功能障碍发生可能性。回归模型具有统计学意义(P<0.05),调整R 2=-0.732。纳入模型的5个自变量中只有血清NSE水平对颅脑损伤与认知功能障碍的相关性具有统计学意义(P<0.05)。结论:有吸烟史、脑挫裂伤、额叶损伤、CT脑出血量较高的轻中度颅脑损伤患者应警惕认知功能障碍发生可能性。轻中度颅脑损伤患者入院时血清NSE含量越高越有可能发生认知功能障碍。Objective:Analyzed the correlation between cognitive dysfunction and the level of nerve-specific enolase(NSE)in patients with mild to moderate craniocerebral injury was.Methods:82 patients with mild to moderate craniocerebral injury were treated from September 2017 to September 2020,the serum NSE of the patients was monitored on admission and the cognitive function was evaluated by the Chinese version of Montreal Cognitive Assessment scale(MoCA)after the patient’s condition was stable.According to the occurrence of cognitive impairment,the patients were divided into normal group and impairment group.Univariate analysis was used to compare the difference of basic clinical data between the two groups,and to further compare the changes of serum NSE in different types and different parts of craniocerebral injury between the normal group and the disorder group.Correlation analysis was made between serum NSE and MoCA score at admission.Multiple linear regression analysis was used to explore the influencing factors of cognitive dysfunction after craniocerebral injury.Results:The serum NSE of patients with subdural hemorrhage,subarachnoid hemorrhage,cerebral contusion injury,frontal lobe,temporal lobe,parietal lobe,and occipital lobe in the obstacle group were all higher than those in the normal group with subdural hemorrhage,and the difference was statistically significan(P<0.05).The serum NSE content of patients with brain contusion and frontal lobe injury at admission was the highest and the difference was the most obvious.The MoCA score of 45 patients was 28(24.50,30.00)in the follow-up 1 year after discharge.Spearman correlation analysis indicated that there was a negative correlation between MoCA score and serum NSE(15.26,2.85)ng/mL in 45 patients at admission(P<0.05).Multiple linear regression was used to predict the likelihood of cognitive dysfunction in patients according to smoking history,injury type,injury type,cranial CT bleeding volume and serum NSE content.The regression model had statistical significanc

关 键 词：轻中度颅脑损伤 认知功能障碍 神经特异性烯醇化酶 相关性 

分 类 号：R749.1[医药卫生—神经病学与精神病学]