血清神经元特异性烯醇化酶对于老年急性脑出血患者的临床意义

目的探讨老年急性脑出血患者血清神经元特异性烯醇化酶(NSE)与出血部位、出血量、神经功能缺损及预后之间的关系。方法选择发病在24 h内老年急性脑出血患者105例,选93例同期健康体检者作为对照组,采用酶联免疫分析法测定两组NSE浓度,按SSS标准评定神经功能缺损及预后,出血量以入院时CT显示计。结果急性脑出血组血清NSE水平与出血部位无明显关系(P>0.05)。急性脑出血组血清NSE水平[少量出血(13.81±3.95)μg/L、中量出血(18.74±4.32)μg/L、大量出血(25.19±3.07)μg/L]显著高于对照组[(8.62±2.64)μg/L],P<0.05。急性脑出血组血清NSE水平与出血量成正比(P<0.05)。急性脑出血组血清NSE水平与神经功能缺损程度呈正相关(r=0.926,P<0.05)。结论血清NSE能够反映神经组织的损害程度,可作为老年急性脑出血病情判断及预后评估的参考指标。

Clinical significance of serum neuron specific enolase for elderly patients with acute cerebral hemorrhage

Objective To investigate the relationship between serum neuron-specific enolase (NSE) and hemorrhagic site,bleeding volume,neurological deficit and prognosis in elderly patients with acute cerebral hemorrhage.Methods 105 patients with acute cerebral hemorrhage incidence within 24 h were selected,and 93 healthy subjects were selected as the control group.The NSE concentration was determined by enzyme-linked immunosorbent assay (ELISA).Neurological deficits and prognosis were assessed according to SSS criteria.The amount of bleeding was measured at admission CT.Results There was no significant correlation between serum NSE level and hemorrhagic position in acute cerebral hemorrhage group (P ＞ 0.05).The serum NSE level in acute cerebral hemorrhage group [little bleeding (13.81 ± 3.95) μg/L,middle bleeding (18.74 ± 4.32) μg/L,large bleeding (25.19 ± 3.07) μg/L] were significantly higher than those in control group [(8.62 ± 2.64) μg/L,P ＜ 0.05].The serum NSE level of acute cerebral hemorrhage group was proportional to bleeding amount (P ＜ 0.05).There was a positive correlation between serum NSE level and neurological deficit in acute cerebral hemorrhage group (r =0.926,P ＜ 0.05).Conclusion Serum NSE can reflect the damage degree of nerve tissue and may be used as an reference index for the diagnosis and prognosis of elderly acute cerebral hemorrhage.