脑出血患者神经元特异性烯醇化酶的变化

目的探讨脑出血（ICH）患者血浆神经元特异性烯醇化酶（NSE）的含量变化及意义。方法59例ICH患者于发病后24h、第3、7、14天测定NSE的含量，同时进行神经功能缺损程度评分以及头CT检查，观察NSE与神经功能缺损程度以及脑水肿的关系。结果NSE在ICH后24h、第3、7、14天均增高，第3、7、14天时NSE含量与神经功能缺损程度以及脑水肿程度呈正相关（P〈0．01），而ICH24h内NSE含量与神经功能缺损程度以及脑出血量无明显相关性（P〉0．05）。结论ICH患者血浆NSE含量的变化反映脑水肿及神经功能缺损的程度，NSE可以作为判断ICH患者病情及预后的检验指标。     

血清神经元特异性烯醇化酶水平与脓毒症相关性脑病的关系

目的：探讨血清神经元特异性烯醇化酶（NSE）水平用于早期评价脓毒症相关性脑病（SAE）严重程度的临床意义。方法：34例SAE患者根据临床转归分为死亡组14例,存活组20例。进行急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）,测定患者入院后24h内的血清NSE浓度,并进行统计学分析。结果：死亡组血清NSE水平和APACHEⅡ评分均明显高于存活组（P〈0．05）,血清NSE水平与APACHEⅡ评分的相关系数是0．619。结论：测定血清NSE水平有助于评价SAE患者病情的严重程度。     

神经元特异性烯醇化酶在脑血管疾病中的研究进展

大量研究结果表明，神经元特异性烯醇化酶是神经元损伤的特异性标志。在脑脊液或血中的浓度水平可反映神经系统损伤的程度和范围大小。测定ＮＳＥ对神经系统疾病的诊断，判断疾病严重程度，估计预后及指导治疗等方面具有重要意义。本文主要对ＮＳＥ在脑血管疾病中的研究进展作一简要综述。     

神经元特异性烯醇化酶异常表达对肺癌诊断价值的研究

肺癌一直是危害人类健康的多发病和常见病,也是当今恶性疾病死亡的主要原因之一。神经元特异性烯醇化酶(ＮＳＥ)是糖酵解中的酶烯醇化酶的同工酶,广泛存在于中枢和周围神经组织及小细胞肺癌(ＳＣＬＣ)中,近来发现在非小细胞肺癌(ＮＳＣＬＣ)中也有升高。对各种肺癌的组织、血清进行了ＮＳＥ测定,以探讨ＮＳＥ在肺癌中的作用。材料与方法　(1)人肺组织标本:收集1999年4月～1999年8月手术后新鲜肺癌组织21份。立即于-85℃冰箱保存。经病理切片诊断,鳞癌12例,腺癌7例,小细胞肺癌2例。(2)肺癌病人血清:收集本院1998年～1999年住院病人中的原发性…     

脑梗死患者血清神经元特异性烯醇化酶的变化

神经元特异性烯醇化酶(NSE)的研究为诊断神经系统疾病提供了新方法,为了探讨脑梗死患者血清神经元特异性烯醇化酶的变化,本文就急性脑梗死(ACI)患者血清神经元特异性烯醇化酶进行了检测,现报道如下。     

奥拉西坦对脑梗死患者血清S100B、神经元特异性烯醇化酶和vWF的影响

目的观察奥拉西坦对脑梗死患者的治疗效果及血清中S100B、神经元特异性烯醇化酶(NSE)和v WF的变化。方法 114例脑梗死患者随机分为两组,对照组(57例)应用常规治疗,并加用丁苯酞胶囊。观察组57例在上述基础上加用奥拉西坦注射液,治疗10 d后观察疗效,并关注血清中S100B、NSE和v WF的变化。结果两组治疗前美国国立卫生研究院脑卒中量表(NIHSS)评分无统计学差异,治疗10 d后,两组NIHSS评分均下降,但是观察组下降值明显高于对照组。两组治疗10 d后血清中S100B、NSE和v WF的表达均下降,但是观察组S100B、NSE和v WF的下降值明显高于对照组。结论奥拉西坦对脑梗死的临床疗效明显,且能有效下调血清中S100B、NSE和v WF表达,保护神经细胞,优化体液环境。     

神经元特异性烯醇化酶在脑血管疾病中的研究进展

大量研究结果表明,神经元特异性烯醇化酶(neuron-specific enolase,NSE)是神经元损伤的特异性标志。在脑脊液或血中的浓度水平可反映神经系统损伤的程度和范围大小。测定NSE对神经系统疾病的诊断、判断疾病严重程度、估计预后及指导治疗等方面具有重要意义。本文主要对NSE在脑血管疾病中的研究进展作一简要综述。     

碘缺乏对大鼠神经元特异性烯醇化酶基因表达的影响

以ＮＳＥ的ｃＤＮＡ制备基因探针，用Ｎｏｒｔｈｅｒｎ ｂｌｏｔ方法检测ＮＳＥ ｍＲＮＡ的相对含量，观察碘缺乏对大鼠ＮＳＥ基因表达的影响，结果表现１日龄和２０日龄低碘甲低大鼠ＮＳＥｍＲＮＡ含量均低于同龄正常大鼠，表明低碘甲低可于转录水平阻碍ＮＳＥ的基因表达。     

甘露醇对急性脑梗死血清神经元特异性烯醇化酶的影响

目的观察20%甘露醇注射液对急性脑梗死患者血液中神经元特异性烯醇化酶的影响,探讨甘露醇对脑的保护作用。方法利用酶联免疫吸附法检测35例脑梗死患者甘露醇注射液治疗过程中血清中的神经元特异性烯醇化酶(neuron-specific enolase NSE)浓度,记录神经功能NIHSS评分,评定临床疗效,并与常规治疗组进行比较。结果甘露醇治疗组第3、7天血液中NSE浓度明显下降,低于常规治疗组,神经功能评分也明显少于常规治疗组(P<0.05)。结论甘露醇对脑神经元有保护作用,能有效改善急性脑梗死患者的神经功能缺损。     

巴曲酶对急性脑梗死患者血清神经元特异性烯醇化酶和神经功能的影响

目的观察巴曲酶对急性脑梗死患者血液中神经元特异性烯醇化酶（NSE）的影响,探讨其对脑神经功能的保护作用。方法 102急性脑梗死患者随机分为治疗组52例、对照组50例。对照组给予常规治疗,治疗组在此基础上加用巴曲酶治疗。观察治疗前后两组血清NSE浓度以及神经功能缺损评分变化。结果巴曲酶治疗组第7天血液中NSE浓度明显下降,低于对照组（P〈0.05）,第14、28天神经功能评分也明显少于对照组（P均〈0.05）。结论巴曲酶可减轻脑梗死患者神经元损伤,能有效改善急性脑梗死患者的神经功能缺损。     

碘缺乏对仔鼠大脑烯醇化酶发育的影响

本实验以严重缺碘地区的粮食复制出接近人类的大鼠缺碘模型，用免疫组化方法研究了碘缺乏对仔鼠大脑ＮＳＥ阳性神经细胞发育的影响。结果显示：实验组Ｔ４水平在各日龄都较对照组低，仔鼠大脑从出生至生后３０日龄ＮＳＥ阳性神经细胞发育较对照组落后，ＮＳＥ免疫阳性产物较少，这种差别在海马区、齿状回、皮层更为明显。表明碘缺乏所致甲状腺功能低下是影响脑发育的直接因素，提示甲状腺素是通过影响ＮＳＥ而干扰能量代谢，造成大脑发育障碍。     

碘缺乏和碘过量对仔二代大鼠海马神经元特异性烯醇化酶活性的影响

目的探讨碘缺乏和碘过量对仔二代Wistar大鼠海马神经元特异性烯醇化酶(NSE)发育的影响。方法按照饮用水含碘(KIO_3)量不同,将大鼠随机分为6组(NI、5HI、10HI、50HI、100HI、LI),取1、20、60日龄仔二代鼠大脑,应用免疫组织化学技术观察海马CA3区神经元,并对NSE反应阳性细胞进行形态学计量分析。结果1日龄:各组仔鼠大脑海马CA3区NSE阳性反应极微弱。20日龄:LI组NSE阳性细胞的细胞核直径、细胞体直径、面数密度和灰度值均比NI组明显减小(P<0.05或<0.01);100HI组面数密度和灰度值小于NI组,差异亦有统计学意义(P<0.05)。60日龄:与NI组比较,LI、100HI组NSE阳性细胞的细胞核直径、细胞体直径、核质比和面数密度均明显减小(P<0.05或<0.01);LI、50HI、100HI组的NSE阳性细胞灰度值均比NI组明显降低(P<0.05或<0.01)。结论碘缺乏和长期严重碘过量使仔二代大鼠大脑海马神经元NSE活性降低,影响神经元的能量代谢,其机制可能与碘缺乏和严重碘过量所致的甲状腺功能低下有关。     

Validation of the association between a branched chain amino acid metabolite profile and extremes of coronary artery disease in patients referred for cardiac catheterization

Objective

To validate independent associations between branched-chain amino acids (BCAA) and other metabolites with coronary artery disease (CAD).

Methods

We conducted mass-spectrometry-based profiling of 63 metabolites in fasting plasma from 1983 sequential patients undergoing cardiac catheterization. Significant CAD was defined as CADindex ≥ 32 (at least one vessel with ≥95% stenosis; N = 995) and no CAD as CADindex ≤ 23 and no previous cardiac events (N = 610). Individuals (N = 378) with CAD severity between these extremes were excluded. Principal components analysis (PCA) reduced large numbers of correlated metabolites into uncorrelated factors. Association between metabolite factors and significant CAD vs. no CAD was tested using logistic regression; and between metabolite factors and severity of CAD was tested using linear regression.

Results

Of twelve PCA-derived metabolite factors, two were associated with CAD in multivariable models: factor 10, composed of BCAA (adjusted odds ratio, OR, 1.20; 95% CI 1.05–1.35, p = 0.005) and factor 7, composed of short-chain acylcarnitines, which include byproducts of BCAA metabolism (adjusted OR 1.30; 95% CI 1.14–1.48, p = 0.001). After adjustment for glycated albumin (marker of insulin resistance [IR]) both factors 7 (p = 0.0001) and 10 (p = 0.004) remained associated with CAD. Severity of CAD as a continuous variable (including patients with non-obstructive disease) was associated with metabolite factors 2, 3, 6, 7, 8 and 9; only factors 7 and 10 were associated in multivariable models.

Conclusions

We validated the independent association of metabolites involved in BCAA metabolism with CAD extremes. These metabolites may be reporting on novel mechanisms of CAD pathogenesis that are independent of IR and diabetes.     

白蛋白输注联合腹腔置管持续引流与支链氨基酸联合利尿剂治疗失代偿期肝硬化张力性腹水的效果对比分析

目的 观察白蛋白输注联合腹腔置管持续引流与支链氨基酸联合利尿剂治疗肝硬化张力性腹水患者的疗效差异。方法 2014年12月~2016年 8月我院收治的78例肝硬化张力性腹水患者被随机分为对照组32例,给予白蛋白联合腹腔置管持续引流治疗,试验组46例接受支链氨基酸联合利尿剂治疗,疗程均为2 w。结果 在治疗2 w末,试验组与对照组肝性脑病（x²=5.472,P<0.05）和自发性细菌性腹膜炎发生率（x²=4.092,P<0.05）有显著性差异;试验组24 h尿量为（1321±278） ml,显著多于对照组的（1102±239） ml（P<0.05）;两组血清TBIL[（36.8±23.1） μmol/L 对（36.3±26.8） μmol/L,P>0.05]、PT-INR [（1.05±0.91）对（1.16±1.03）,P>0.05]、 ALB[（32.9±9.1） g/L 对（30.7±8.5） g/L,P>0.05]、Cr [（65.2±45.7）μmol/L对（72.4±38.8）μmol/L,P>0.05]均无显著性相差。结论 白蛋白联合腹腔置管持续引流是治疗肝硬化张力性腹水公认有效的方法,而应用支链氨基酸联合利尿剂具有相对安全、剂量可控、价格低廉、无创的特点,短期效果也较好。     

神经元特异性烯醇化酶检测在小细胞肺癌预后中的价值

目的 评价化疗前后血清神经元特异性烯醇化酶（NSE）检测在非手术治疗小细胞肺癌（SCLC）患者中的预后价值。方法 收集1997年6月－2000年12月上海市肺科医院内科收治144例SCLC患者,均于化疗前（D1）和化疗后21d(D21)检测NSE水平,进行预后单因素和多因素分析。结果 144例患者中D1－NSE阳性98例,占68.1%;阴性46例,占31.9%。D210－NSE阳性57例,占39.6%;阴性87例,占60.4%;单因素分析D1－NSE和D21－NSE均是提示预后有价值的指标;但COX多因素分析时,只有D21－NSE是提示预后的独立指标。结论 D21－NSE是提示小细胞肺癌预后的独立指标,在临床上有较重要的应用价值。     

Effect of sulphonylurea administration on insulin secretion and amino acid metabolism in non-insulin-dependent diabetic patients

Sulphonylureas lower blood glucose but other metabolic effects have been little studied. In an assessment of carbohydrate and amino acid metabolism in 9 patients with non-insulin-dependent diabetes mellitus (NIDDM) before and after 3 months' therapy with gliclazide, glycaemic control was improved (mean +/- S.D. glycosylated haemoglobin 13.8 +/- 1.9% before therapy, 10.2 +/- 2.1% after therapy (p less than 0.01], but fasting amino acid levels were not altered. In contrast, postprandial levels of branched chain amino acids (BCAA) were significantly reduced: total BCAA (valine, leucine, and isoleucine) 120 mins following a standard test meal fell from 717 +/- 71 mumol/l before therapy to 600 +/- 90 mumol/l after 3 months' therapy (p less than 0.01). This finding implies an increased action of endogenous insulin on skeletal muscle to promote uptake of BCAA postprandially and, in accord with this, peripheral insulin levels were significantly increased following drug treatment (peak insulin level 55.6 +/- 20.2 mU/l before therapy, 91.3 +/- 17.9 mU/l after therapy (p less than 0.01]. Sulphonylurea drugs therefore do not simply have a hypoglycaemic action but also affect amino acid metabolism in NIDDM patients.     

Dietetic supplementation with branched chain amino acids attenuates the severity of streptozotocin-induced diabetes in rats

Summary Previous studies showed that the diabetogenic action of streptozotocin is reduced in rats adapted to a high-protein, carbohydrate-free diet, that have markedly elevated plasma concentrations of valine, leucine and isoleucine. In order to test the role of these branched chain amino acids (BCAA) in the beneficial effects of the high-protein diets, rats adapted (15 days) either to a balanced synthetic diet, or to the same diet supplemented with BCAA were injected with streptozotocin (STZ) (40 mg/kg body weight) and maintained on the same diets after drug injection. Rats previously fed the BCAA enriched diet showed a partial but significant reduction in the severity of diabetes, as indicated by higher rates of body weight gain, lower food and water intake, lower excretion of glucose and higher serum insulin levels. Rats previously fed the control diet for 14 days, but transferred to the BCAA diet 3 days after STZ injection, also showed reduced severity of diabetes, as indicated by rates of body weight gain, water and food ingestion, glucose and insulin levels. The data suggest that the increased supply of BCAA is responsible, at least in part, for the previously reported beneficial effects of high-protein diets in rats with STZ-induced diabetes.     

碘过量对大鼠子代神经元特异性烯醇化酶表达的影响

目的观察碘过量对大鼠子代脑神经元特异性烯醇化酶表达的影响。方法根据饮用水碘剂量的不同,将断乳后1个月Wistar大鼠随机分为5组(NI、5HI、10HI、50HI、100HI)。饲养3个月后雌雄合笼,取子一代1、20、60日龄仔鼠,测血清甲状腺激素(T3、T4),免疫组织化学染色,光镜下观察碘过量对脑神经元特异性烯醇化酶(NSE)表达的影响,图像分析不同日龄仔鼠的大脑发育情况。结果碘过量组(5HI、10HI、50HI、100HI)血清甲状腺激素水平在生后1日和20日龄时与对照组(NI)比较无明显差别在60日龄,各碘过量组甲状腺激素呈下降趋势,100HI组[T4=(37.52±8.69)nmol/L、T3=(0.61±0.16)nmol/L]与NI组[T4=(59.42±17.56)nmol/L、T3=(1.13±0.34)nmol/L]比较,差异有统计学意义(t=4.38、5.44,P<0.01)。NSE的免疫组化和形态计量学显示:海马CA3区NSE阳性细胞的数密度(NA)、体密度(VV)和灰度值随碘过量的严重程度而下降,100HI组[NA=(30.38±2.49)/mm2、VV=(0.100±0.012)、灰度值=(139.81±11.11)]与NI组[NA=(34.63±2.31)/mm2、VV=(0.122±0.018)、灰度值=(149.05±6.83)]比较,差异有统计学意义(t=4.54、3.86,P<0.01;t=2.62,P<0.05)。结论大鼠对碘摄入量的增加有较强的耐受性,在100HI组可以观察到以NSE表达降低为主要特点的脑发育障碍,其发病机理与碘过量所致的甲状腺功能低下有关。     

Influence of glutamine and branched chain amino acids on the jejunal atrophy associated with parenteral nutrition

Infusions of conventional parenteral nutrients (CPN) are associated with gut atrophy. This may be due to the absence of glutamine in such solutions. Although glutamine is a preferred gut nutrient, it is excluded from CPN because it is unstable at room temperature. This problem may be circumvented either directly by the infusion of fresh solutions of glutamine, or indirectly by the infusion of branched chain amino acids (BCAA). We evaluated the effect of infusing either glutamine, BCAA, or glutamine plus BCAA-enriched CPN on the rat jejunum. Sixty male Wistar rats were randomized to receive 6 days of either conventional parenteral nutrition (CPN), CPN plus 1.5% glutamine (GLN), CPN plus 2% BCAA (BCAA), CPN plus 0.8% BCAA and 1.0% glutamine (GLN/BCAA), or a normal oral diet (Chow). Standardized segments of jejunum were then removed for assessment. Compared with the CPN group, both the GLN/BCAA and the BCAA groups had greater mucosal weights (P less than 0.05) and mucosal protein concentrations (P less than 0.05), the GLN/BCAA group had greater jejunal weights (P less than 0.05), and the GLN group had an increased jejunal weight (P less than 0.05) and a higher crypt cell production rate (P less than 0.05). We conclude that the infusion of glutamine or BCAA-enriched parenteral nutrition improves jejunal morphology compared with conventional parenteral nutrition.