颅脑外伤后血浆神经元特异性烯醇化酶的变化及其与临床CT 颅内压 脑灌注压的相关研究  

Study on change of NSE in plasma and their correlation with clinical feature,CT,ICP,CPP in patients with brain injury

作　　者：董家军[1] 王维平 

机构地区：[1]苏州大学附属第二医院神经外科,江苏苏州215004 [2]上海瑞金集团闵行医院神经外科

出　　处：《中国急救医学》2004年第3期190-192,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的　①探讨颅脑外伤后血浆神经元特异性烯醇化酶 (NSE)变化规律 ;②探讨血浆NSE水平与伤情、CT、ICP、CCP的关系。方法　放射免疫法测定 6 0例各型颅脑损伤患者 2 4h内、3d、7d血浆NSE水平 ,并结合颅脑损伤程度、CT、ICP、CPP进行分析。结果　①颅脑损伤患者伤后血浆NSE浓度立即升高 ,其程度与脑损伤程度呈正相关。②血浆NSE水平与ICP正相关 ,与CPP负相关。③血浆NSE水平随CT图像改变而变化。结论　①通过对血浆NSE浓度变化的动态观察 ,为颅脑损伤程度的判断提供较为实用的指标。②监测血浆NSE浓度 ,联合CT、ICP、CPP等指标 ,可更准确地判断病情 ,为临床治疗提供依据。Objective ①To investigate the variable levels of serum neuron-specific enolase(NSE)in patients with brain injury.② To determine the correlation between the levels of NSE and brain injury degree,CT scan,intracranial pressure(ICP),cerebral perfusion pressure(CPP).Methods Plasma NSE levels in sixty adult patients with acute brain injury were measured by using the isotope radioimmunoassay within 24 hours on the third day and the seventh day after injury. The relationship between the plasma NSE level and graduation of injury,CT,ICP,CPP were analysed. Results ①After traumatic brain injury,serum NSE concentrations increased immediately and related to the degree of lesion. ②The concentrations of serum NSE positively correlated with ICP. ③As CT scans changed,the serum NSE concentrations varied.Conclusion ① The changes of plasma NSE were treated as a relevant biochemical parameter for assessing the lesion degree,and it may contribute to improve the therapeutic management of severe head injury.② The concentrations of serum NSE ,CT scan,ICP and CPP were helpful in evaluating the neurological state of head injured patients,and also helpful in treating such patients.

关 键 词：颅脑损伤 磷酸丙酮酸水合酶 CT 颅内压 脑灌注压 

分 类 号：R651.15[医药卫生—外科学]