出血性脑卒中患者血清和脑脊液神经元特异性烯醇化酶含量变化的研究

目的：观察出血性脑卒中患者发病早期血清及脑脊液中神经元特异性烯醇化酶（NSE）的变化,探讨二者之间的关系及其与预后的关系。方法：采用ELISA法检测40例出血性脑卒中患者发病24 h内及第3、7、14天的血清和脑脊液NSE水平,结合患者的GCS评分及发病第30天时的GOS评分等资料进行数据统计分析。结果：出血性脑卒中患者血液和脑脊液NSE水平与病情轻重有关;NSE平均水平在卒中后3～7 d达高峰,7～14 d逐渐下降。发病后早期（14 d内）同一时间点,患者病情越重,GCS评分越低,血清及脑脊液中的NSE值越高（P〈0.001）;预后不良组血清及脑脊液NSE水平增高,较预后良好组有统计学意义（P〈0.05）。发病后早期（14 d内）同一患者脑脊液NSE值较血清NSE值高（P〈0.05）。出血性脑卒中患者发病早期,血液和脑脊液NSE含量呈正相关（r=0.966,P〈0.05）。结论：NSE作为神经元损伤的定量生化标志物,其水平高低不仅能反映脑卒中后脑组织及神经功能损伤的严重程度,而且可作为出血性脑卒中患者病情监测和预后评估的一项重要指标。

Study on the content changes of neuron specific enolase in serum and cerebrospinal fluid of patients with hemorrhagic stroke

Objective： To investigate the changes of neuron specific enolase（NSE） in serum and cerebrospinal fluid（CSF） of patients with hemorrhagic stroke in acute stage,and the relationship between them.Methods： Samples of serum and CSF were examined on day 1,3,7 and 14 after onset in 40 patients with hemorrhagic stroke by enzyme-linked immunosorbent assay（ELISA） and analyzed statistically.Clinical outcome was assessed on the 30th day after onset with the Glasgow Outcome Scale（GOS）and Glasgow Coma Score（GCS）.Results： The levels of NSE in hemorrhagic stroke were associated with the severity of the disease.It reached maximum within 3-7 days,and decreased within 7-14 days.In the early stage after onset（within 14 days）,the more severe the condition at the corresponding time points,the lower GCS score,the value of NSE was higher（P〈0.001）;the levels of NSE in serum and cerebrospinal fluid in the excellent prognosis group increased,and there were significant diferences between the excellent prognosis group and worse prognosis group（P〈0.05）;in the same patient,the value of NSE in CSF was higher compared to the serum one（P〈0.05）.The contents of NSE in serum and CSF in patients with hemorrhagic stroke were positive correlation（r=0.966,P〈0.05）.Conclusion： It indicates that NSE may serve as quantitative biochemical markers,and its levels may reflect the degree of brain damage.As well as,it may prove to be an index of monitor and prognosis in patients with hemorrhagic stroke.