神经元特异性烯醇化酶检测对颅脑损伤诊断分型及判断预后的临床意义

目的：探讨急性颅脑损伤患者检测血清神经元特异性烯醇化酶（neuron-specific enolase,NSE）的含量及动态变化,对颅脑损伤的诊断分型、评估伤情和判断预后的临床价值.方法：采用放射免疫法,对185例急性颅脑损伤患者（观察组）及50名健康体检人群（对照组）血清NSE水平进行检测.分别于颅脑损伤后1、3、7、10sd NSE水平进行动态检测和观察.结果：观察组颅脑损伤后1 d血清NSE水平均显著高于对照组（P〈0.01）,与格拉斯哥昏迷评分呈负相关关系（P＜0.05）;动态检测血清NSE水平显示重型颅脑损伤患者虽经积极救治,血清NSE水平均持续高于中型颅脑损伤患者（P〈0.01）.结论：检测患者颅脑损伤后血清NSE水平可以直接反映脑细胞损害程度,是一项较为敏感的生化指标,特别是动态检测血清NSE水平对判断颅脑损伤后伤情评估、疗效观察及预后具有一定的临床意义.

The clinical significance of neuron-specific enolase in the classification and prognosis of craniocerebral injury

Objective： To investigate the serum level and clinical value in the classification, evaluating disease and prognosis of neuron-specific enolase（NSE） in patients with acute craniocerebral injury. Methods： The serum levels of NSE in 185 patients with acute craniocerebral injury （observation group） and 50 healthy people （control group） were detected using radioimmunoassay. The dynamic serum levels of NSE were observed at 1,3,4 and 10 days after craniocerebral injury. Results： The serum levels of NSE in observation group at 1 day after craniocerebral injury were significantly higher than those in control group （ P 〈 0.01 ）, which was negatively correlated with Glasgow consciousness disorders（ P 〈0.05 ）. The dynamic detection of NSE showed that the serum levels of NSE in patients with severe craniocerebral injury were consistently higher than those in moderate craniocerebral injury after active treatment（P 〈 0.01 ）. Conclusions： The serum levels of NSE in patients with craniocerebral injury can directly reflect the damage degree of brain cells, which is a sensitive biochemical index. The dynamic detection of serum NSE level has certain clinical significance in evaluating disease and prognosis of craniocerebral injury.