血清磷酸丙酮酸水合酶在脑损伤中的临床诊断价值

 目的 研究血清神经烯醇化酶（Nse）在早期诊断放射性脑损伤中的作用。方法 采用酶联免疫吸附试验检测56例颅内恶性肿瘤患者（脑转移瘤26例，脑瘤30例）在接受放射性治疗前、后的血清Nse水平，利用成组设计的方差分析比较其差异。同时比较颅内恶性肿瘤患者不同放疗方案（普通放疗组32例;适形放疗组24例）、瘤周水肿程度(轻度18例，中度的20例，重度的18例)对血清Nse水平的影响，比较其差异。 结果 放疗前对照组与脑瘤组血清Nse水平分别为4.12μg/L、4.66μg/L，差异无统计学意义（t= 1.48 P= 0.186 ）; 脑瘤组放疗前、后血清Nse水平分别为4.66μg/L、7.84μg/L，差异有统计学意义（t=3.89 P= 0.001）；普通放疗与适形放疗组血清Nse水平分别为13.59μg/L、6.14μg/L，差异有统计学意义（t= 3.73 P=0.002 ）；放疗后水肿程度（轻、中、重）血清Nse水平分别为4.47μg/L、6.87μg/L、15.21μg/L，差异有统计学意义（F=15.61 P=0.0001）。而放疗前三种水肿程度的患者血清NSE水平无显著性差异 （P>0.05） . 结论 脑瘤组在放疗前不存在或存在轻微的脑损伤，放疗后其血清Nse水平明显增高，其与放疗造成不同程度脑损伤有关；适形放疗组较普通放疗组血清Nse水平低，说明适形放疗能减少脑损伤的发生；重度脑水肿组血清Nse的水平要明显高于其他两组，可能与重度水肿损伤脑神经细胞较多所致。因此Nse可作为脑损伤的临床标志物，为脑损伤的预防和治疗提供依据。

Value of serum phosphopyruvate hydratase protein for the diagnosis of cerebral injuries in patients with brain malignant tumor

Objective To study the value of serum phosphopyruvate hydratase PH protein for the diagnosis of cerebral injuries in patients with brain malignant tumor. Methods Serum PH protein levels were detected by enzyme-linked immunosorbent assay in 56 patients with brain malignant tumor. Compare the differences among the status of cerebral injuries. And compare the differences among the patients with general with different radiotherapy methods 32 cases, three dimensional confonnal radiothrapy 24 cases, and different peritumoral brain edema levels （cmild 18 cases, moderate ao cases severe 30 cases）. Results Before radiotherapy the levels of serum PH protein in patients and the health control were （4.12±0.56）, （4.66±0.2） μg/L,no significant differece（P〉0.05）. And there was also no significant difference between the before and after radiotherapy for the cerebroma, the levels were（7.84±0.2）μg/L, （t=3.89,P= 0.001）. The PH levels of general radiation therapy and three dimensional comformal radiotherapy were （13.59±0.2）,（6.14±0.2）μg/L. There was cignificant difference（P=0.002） After radiotherapy, The levels of serum PH protein of the different dropsical degree, mild, moderate and severe were （4.47±0.5）,（6.17±0.2）,（15.21 ±0.6） μg/L, respectively, showing significant difference （F =15.61,P =0.0001 ）. The therapies influenced the serum PH levels （P 〈0.05） Conclusion High levels of sermn PH protein are associated with severe cerebral injuries in brain malignant tumor. So high serum PH level may serve as an progressive predictor of the injury.