脑出血病人血浆神经元特异性烯醇化酶及凝血酶含量动态变化的研究

目的探讨脑出血病人血浆神经元特异性烯醇化酶（NSE）和凝血酶含量变化及其临床意义。方法测定32例脑出血病人发病后24h、第7天和第14天血浆内NSE和凝血酶含量，并对二者含量的变化及其与脑组织水肿体积、神经功能缺损评分进行相关分析。结果NSE和凝血酶在发病后24h内、第7天、第14天明显高于正常对照值（P〈0．01）；第7天升高最明显。二者的含量变化具有正相关性（r=0．643，P〈0．01），尤其是以发病后24h和第7天更为明显（r=0．533。P〈0．001）。第14天时NSE、凝血酶含量与脑水肿体积呈明显的正相关（r=0，275，0．306，P〈0．01）。NSE、凝血酶含量与病后24h内神经功能缺损评分并无明显的相关性（P〉0．05）；第7天和第14天神经功能缺损评分具有正相关性（P〈0．01或P〈0．05）。结论脑出血病人血浆内NSE含量的变化可反映凝血酶所致的脑组织水肿的情况；动态监测NSE、凝血酶含量可以作为判断脑组织水肿和评估神经功能缺损程度的临床指标。     

急性脑梗死患者血清神经元特异性烯醇化酶水平变化及意义

目的探讨急性脑梗死（ACI）患者血清神经元特异性烯醇化酶（NSE）动态变化的临床意义。方法采用酶联免疫吸附（ELISA）法检测40例ACI患者（观察组）血清NSE水平,并分析其与梗死体积、神经功能缺损程度[斯堪的那维亚卒中量表（SSS）评分分型]及梗死部位的关系。结果观察组血清NSE水平明显高于对照组（30例健康人）,P〈0.01;NSE水平与梗死灶体积和神经功能缺损程度呈正相关（P〈0.01）。结论NSE是反映脑内神经元损伤或坏死的客观指标;可作为ACI早期诊断、判断病情转归和预后的综合指标。     

急性脑梗死血清中神经元特异性烯醇化酶水平的变化及意义研究

目的探讨急性脑梗死患者血清中神经元特异性烯醇化酶（NSE）水平的变化及意义。方法采用ELISA法测定40例急性脑梗死患者和30例性别、年龄结构相匹配的健康人血清中NSE水平,应用CT扫描测定脑梗死体积和斯堪的那维亚卒中量表（SNSS）进行神经功能缺损评分。结果急性脑梗死患者血清中NSE水平显著高于对照组（P〈0.01）,血清中NSE水平与脑梗死面积和神经功能缺失程度呈显著正相关（P〈0.05）。结论急性脑梗死患者血清中NSE水平增高与神经元坏死有关,NSE水平的高低可以反映脑梗死面积的大小,为脑梗死后神经元损伤程度提供定量信息。     

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。     

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。     

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。     

碘过量对大鼠脑神经元特异性烯醇化酶基因表达的影响

目的 观察碘过量对大鼠脑神经元特异性烯醇化酶(NSE)基因表达的影响.方法 选用150只断乳1月龄的健康Wistar大鼠,按5×2析因设计分为10组.每组15只.按摄碘量分为正常碘(NI)、5倍碘(5HI)、10倍碘(10HI)、50倍碘(50HI)、100倍碘(100HI)5个水平,饲喂时间为3、6个月.实验期满后,取全部大鼠血样,用放射免疫分析方法测定血清总甲状腺素(TT4)、总三碘甲状腺原氨酸(TT3)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、反三碘甲状腺原氨酸(rT3)水平;取大鼠脑组织,采用RT-PCR方法检测脑组织NSE mRNA的表达.结果 各碘水平组TT4、TT3变化明星(F值分别为18.867、27.287,P<0.01),时间和碘水平对TT4存在交互作用(F=2.486,P<0.05);100HI组TT4、TT3均低于同时间NI、5HI、10HI、50HI组(P均<0.01).血清FT4、FT3、rT3水平,在3、6个月时变化明显(F值分别为4.968、27.046、59.776,P<0.05或<0.01),各碘水平组间变化明显(F值分别为33.058、28.420、17.482,P均<0.01),时间和碘水平对FT3、rT3存在交互作用(F值分别为6.894、5.233,P均<0.01);100HI组FT4、FT3、rT3低于同时间其他组(P<0.01或<0.05).各碘水平间NSE mRNA变化明显(F=29.006,P均<0.05);3、6个月100HI组大鼠脑中NSE mRNA水平(0.61±0.19、0.61±0.22),与NI(0.73±0.13、0.72±0.26)、5HI(0.72±0.15、0.72±0.16)、10HI(0.73±0.32、0.70±0.13)、50HI(0.71±0.18、0.69±0.31)组比较降低(P均<0.05).3、6个月时血清FT3、FT4与NSE mRNA水平均存在相关关系(r值分别为0.987、0.969及0.890、0.910,P均<0.05).结论 NSE基因的表达对过量碘摄入呈现出耐受性且有一定的阈值;当过量碘摄人为正常100倍时,在转录水平影响NSE基因的表达,表现为抑制NSE mRNA水平;在过量碘引发NSE转录减低的调控中,FT4和FT3可能均起着重要作用.     

肝癌细胞BEL7402中神经元特异性烯醇化酶的表达

目的:分别从转录水平、蛋白水平及细胞水平检测人神经元特异性烯醇化酶(NSE)在肝癌细胞BEL7402中的表达情况.方法:利用NSE特异引物,通过逆转录聚合酶链式反应(RT-PCR)从人肝癌细胞BEL7402中扩增人NSE基因的转录产物,采用免疫印迹(Westernblot)、免疫细胞化学(ICC)染色技术检测NSE在肝癌细胞中的表达.结果:通过RT-PCR方法可以从BEL7402中扩增1305bp的NSE产物;Westernblot方法证实BEL7402细胞可以表达Mr50000的NSE蛋白;免疫细胞化学染色显示BEL7402与抗NSE单抗呈阳性反应,这说明从转录水平、蛋白水平及细胞水平均检测到了NSE在肝癌细胞BEL7402中的表达.结论:NSE可在肝癌细胞BEL7402转录和表达.     

Decreased red cell enolase activity in a 40-year-old woman with compensated haemolysis

A 40-year-old woman splenectomized 17 years previously for hereditary haemolytic anaemia was investigated in our laboratory because of persistent conjunctival subic-terus associated with compensated haemolysis. The results of the autohaemolysis and osmotic fragility tests were similar to those usually observed in hereditary spherocytosis. Red cell enzyme assays indicated a decreased amount of kinetically normal enolase. The genetic transmission of this defect could not be established since the only other affected member of the family was the proposita's father who died several years ago after splenectomy for an undefined haemolytic disorder.     

血清ProGRP和NSE在晚期非小细胞肺癌中的表达及其临床意义

目的 探讨血清胃泌素释放肽前体(ProGRP)和神经元特异性烯醇化酶(NSE)在晚期非小细胞肺癌中的表达及其临床意义.方法 收集晚期非小细胞肺癌患者75例,采用电化学发光免疫分析法检测血清中PorGRP和NSE的表达.结果 不同年龄、性别、吸烟史、美国东部肿瘤协作组(ECOG)评分及分化程度的晚期非小细胞肺癌患者血清P...     

急性脑缺血患者血浆NSE水平动态观察意义

目的：研究缺血性脑卒中患者血浆神经元特异性烯醇酶（Neuron-specific enolase,NSE)的变化及与预后的关系。方法：病例组50例,正常对照组30例。患者分别于入院24小时内,第2天至第7天连续采集血标本。血浆NSE测定采用酶联免疫分析方法,神经功能缺损评定按斯堪的纳维亚卒中量表（SSS）标准进行。结果：病例组3天内血浆NSE明显高于对照组（P＜0．01）。NSE 变化是一个动态变化过程,预后恶化组血浆NSE7天后仍明显高干预良好组（P＜0．01）。结论：脑缺血早期NSE血浆明显升高,NSE的动态变化反映了缺血后神经元的损伤是一个动态变化过程,7－10天血浆NSE居高不下者预后差。     

Detection and diagnostic value of serum NSE and S100B protein levels in patients with seizures associated with mild gastroenteritis: A retrospective observational study

Benign convulsions with mild gastroenteritis (CwG) and febrile seizures (FS) associated with mild gastroenteritis are 2 different diseases in the spectrum of seizures associated with mild gastroenteritis. However, specific and useful indicators for the identification of the 2 diseases are lacking. A retrospective analysis was performed to compare the serum neuronal-specific enolase (NSE) and S100B protein levels between patients with these 2 diseases to evaluate the value of NSE and S100B for differential diagnosis between these 2 diseases.The clinical data and NSE and S100B protein levels of 81 children with seizure-associated mild gastroenteritis were collected. According to the axillary temperature at the time of convulsions, all patients were classified into an afebrile seizure (AFS) group, hereafter called the CwG group (n = 46), and a febrile seizure group (FS group, n = 35).The serum NSE level was higher in the CwG group than in the FS group (14.046 (11.095, 19.266) pg/ml and 9.034 (7.158, 12.165) pg/ml, respectively, P < .001); however, the serum S100B protein levels in the CwG and the FS group were not significantly different (P > .05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for NSE was 0.806, P = .000, which was statistically significant. The Youden index was largest (0.605) for a serum NSE cut-off value of 10.460 pg/ml, which yielded a sensitivity and specificity of 89% and 71%, respectively, for prediction of a CwG diagnosis.NSE may contribute to the differential diagnosis of CwG and FS associated with mild gastroenteritis.     

血清神经元烯醇化酶水平对急性脑梗死患者转归的预测价值

目的 探讨血清神经元烯醇化酶（NSE）水平与急性脑梗死患者短期预后的相关性.方法 选择急性脑梗死患者100例,出院时根据评定改良Rankin量表评分（mRS评分）对患者进行分组,mRS评分0～2分为预后良好组,mRS评分3～6分为预后不良组.比较两组血清NSE水平以及临床资料.结果 预后良好组62例,预后不良组38例.两组年龄、性别、高血压病、2型糖尿病、高脂血症、缺血性心脏病、TIA、既往卒中、吸烟和喝酒史比较,差异无统计学意义（P均＞0.05）.预后不良组患者入院NIHSS为10.0分,NSE水平13.8 mg/L,预后良好组分别为4.0分和10.8 mg/L,P均＜0.01.多因素Logistic回归分析显示,NSE水平为预后不良患者的独立危险因素（OR=1.180,95％CI：1.029 ～ 1.351,P=0.017）.以血清NSE水平预测患者预后不良的Cutoff值为＞11.87 mg/L,其曲线下面积为0.732（P ＜0.001）.结论 血清NSE水平是判断急性脑梗死患者预后的良好生物指标.     

Changes to levels of serum neuron-specific enolase in a patient with small cell carcinoma of the pancreas

Small cell carcinoma (SCC) of the pancreas is a rare disease, with an extremely poor prognosis; only 24 cases have been reported in the literature. However, as some patients have been successfully treated with combination chemotherapy, it is important to obtain both a definite diagnosis and a precise evaluation of the effect of the treatment. A 69-year-old woman presented with an abdominal tumor and pain. She had been observed for sensory neuropathy and swelling of the pancreatic head by the referring doctor over the previous 9 months. The patient was diagnosed with SCC of the pancreas after surgery and had two courses of combination chemotherapy (cisplatin and etoposide). Initially, the tumor disappeared completely on computed tomography (CT) scans, but she died of disease recurrence 3 months after completing the chemotherapy. Changes in serum neuron-specific enolase (NSE) levels were monitored constantly during the progress of the disease. NSE levels had already increased above the upper limit of normal 8 months before the patient’s admission to our hospital, and levels changed concurrently not only with tumor growth but also subsequently with remission and then relapse of the disease after treatment. These results indicate that NSE is a good marker, both as a diagnostic indicator for SCC of the pancreas and as a means of evaluating response to treatment.     

黄花蒿花粉新过敏原烯醇化酶鉴定:重组纯化及IgE结合活性

目的 分析并鉴定黄花蒿花粉中新过敏原烯醇化酶以及致敏性.方法 通过对黄花蒿花粉转录组学研究,得到潜在过敏原烯醇化酶的基因序列,通过序列扩增、重组表达和纯化获得重组黄花蒿花粉烯醇化酶,结合过敏患者血清和酶联免疫吸附实验(ELISA)、免疫印迹实验(Western blot)和竞争抑制实验研究黄花蒿花粉烯醇化酶的IgE结合...     

神经元特异性烯醇化酶对癌性胸水诊断价值的Meta分析

目的探讨测定胸水中神经元特异性烯醇化酶（NSE）水平对癌性胸水的诊断价值。方法制定纳入标准对相关文献进行采集,然后通过随机效应模型汇总并提炼出Meta分析所需指标,计算出NSE诊断癌性胸水的灵敏度、特异度以及其他指标,绘制汇总受试者工作特征（ROC）曲线并分析其诊断价值。结果最终有10项独立研究符合纳入标准被收入此次Meta分析,NSE诊断癌性胸水的总体灵敏度为0．29（95％C10．25～0．33）,特异度为0．87（95％C10．84～0．89）,阳性似然比为3．67（95％CI2．06—6．54）,阴性似然比为0．77（95％C10．63～0．95）,诊断优势比为5．24（95％CI2．22—12．38）。结论NSE诊断癌性胸水的灵敏度、特异度不高,测定胸水中NSE水平对癌性胸水的诊断价值不大。分析胸水的NSE水平应该结合临床表现以及常规的检查结果。     

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。     

Neuron-specific enolase in medullary thyroid carcinoma: immunohistochemical demonstration,but no significance as serum tumor marker

Summary Neuron-specific enolase (NSE) is an enzyme detectable in nervous and neuroendocrine tissue. Increased serum levels of NSE are found in small cell lung cancer and in patients with neuroblastoma, in whom NSE is used as a serum tumor marker. We have investigated 32 patients with histologically proven medullary thyroid carcinoma, a tumor of neuroendocrine origin, in which the classical tumor marker calcitonin (CT) was pathologically elevated. Positive immunocytochemistry for NSE and CT in C-cells was obtained in all cases. Increased serum NSE levels were found in only 5 of 32 patients, there was no correlation between NSE and CT concentrations. We also compared NSE and CT serum levels during long-term follow-up and again found no correlation between NSE and CT. After i.v. stimulation tests with pentagastrin and calcium, no correlation was found between NSE and CT serum levels. We conclude, therefore, that in medullary thyroid carcinoma NSE is useful for immunocytochemistry but not a reliable serum tumor marker.This study was supported by Tumorzentrum Heidelberg/Mannheim; Schwerpunkt Schilddrüsencarcinom.     

大鼠小脑颗粒神经元体外原代培养

目的 体外原代培养大鼠小脑颗粒神经元,为研究慢性砷暴露对小脑神经元的毒性作用提供实验方法.方法 取生后5～7天Wistar仔鼠,体式显微镜下分离小脑皮层,0.25％胰蛋白酶消化、DNA Ⅰ酶洗涤制成单细胞悬液,两次差速贴壁后接种在多聚赖氨酸包被的培养板内,相差镜下观察大鼠小脑颗粒神经元成长、发育变化及突触形成.采用神经元特异性烯醇化酶(NSE)免疫荧光技术鉴定神经元.结果 培养后第24小时,相差显微镜下可见大鼠小脑颗粒神经元贴壁,呈网状排列;第2～3天,神经元胞体由椭圆形变成圆形,轮廓逐渐清晰,细胞伸出突起,突起逐渐延长,细胞间通过突起连接,形成了稀疏的神经元突触网络;第4～6天,细胞体积进一步增大,细胞间通过广泛的突触联系,神经元清晰饱满,形成了复杂的神经元网络.共聚焦显微镜下,可见大量含NSE的神经元.结论 成功地进行了大鼠小脑颗粒神经元的原代培养,该方法可为今后研究慢性砷暴露对小脑细胞的毒性作用提供实验依据.