ACI患者治疗前后血清NSE和hs-CRP检测的临床意义探讨

目的：探讨急性脑梗死（ACI）患者治疗前后血清神经元特异性烯醇化酶（NSE）和超敏C-反应蛋白（hs-CRP）水平的变化及临床意义。方法：应用发光免疫分析和免疫荧光定量技术对51例ACI患者治疗前后血清NSE和hs-CRP水平进行动态检测,并与98例正常人的检测结果作比较。结果：治疗前ACI患者血清NSE和hs-CRP水平均显著高于正常对照组（P〈0.001）,发现大面积脑梗死组治疗前血清NSE和hs-CRP水平〉中面积组（P〈0.01）〉小面积组（P〈0.01）。且ACI患者治疗前血清NSE和hs-CRP的含量与梗死灶面积密切相关（r（1）=0.8811,P〈0.01;r（2）=0.7913,P〈0.01）。治疗1周血清NSE和hs-CRP水平均显著下降（P1〈0.05,P2〈0.01）,治疗后2周hs-CRP水平与正常对照组差异无统计学意义（P〉0.05）,NSE水平仍明显高于正常对照组（P〈0.01）。结论：检测ACI患者血清NSE和hs-CRP水平的变化不仅有助于脑梗死的诊断和病情及预后的判断,而且对于疗效的评估、指导临床实践亦有价值。

Study on the Clinical Significance of Determination of Changes of Serum NSE and hs-CRP Levels After Treatment in Patients with Acute Cerebral Infarction

Objective To study the clinical significance of changes of serum NSE and CRP levels after treatment in patients with acute cerebral infacrction.Methods Serum NSE（with CLIA）and hs-CRP（with immuno-fluroscence technic）levels were measured in 51 patients with acute cerebral infarction（large size,n=11,medium size,n=19,small size,n=21）for 3 times（before treatment,1wk later,2wk later）and once in 98 controls.Results Before treatment,the serum NSE and hs-CRP levels in the patients were significantly higher than those in the controls（P0.001）.Among the patients,serum levels of NSE and CRP in the patients with large size infarction were significantly higher than those in patients with medium size infarction（P0.01）,and the levels in patients with medium size infarction were again significantly higher than those in patients with small size infarction（P0.01）,i.e.the infarction size was significantly positively correlated with the serum NSE and hs-CRP levels（r=0.8811,0.7913,P0.01,0.01）.After two weeks＇ treatment,in the 45 survivors,the serum hs-CRP levels were not much different from those in controls（P0.05）,however,the NSE levels,though dropped significantly,still remained significantly higher than those in controls（P0.01）.Moreover,in the six deceased patients,the serum NSE levels increased continuously before death.Conclusion Dynamic monitoring of serum NSE and hs-CRP levels was clinically useful for assessment of the severity and progress of the disease process in patients with acute cerebral infarction.