55例多梗塞性痴呆患者脑脊液TNF和NSE的测定及其临床意义

目的　研究多梗塞性痴呆 (MID)患者脑脊液 (CSF)中肿瘤坏死因子 (TNF α)和神经元特异性烯醇酶 (NSE)的含量变化及临床意义。方法　采用放射免疫分析法对 55例MID患者CSF中TNF α进行测定 ;采用双抗体夹心ELISA法测定NSE浓度。并与同期住院的 72例脑梗塞 (CI)患者及 3 2例神经系统功能性疾病 (Control)患者进行比较。患者的智能水平测定采用简易智能量表(MMSE) ,并参考Hachinski缺血评分及DSM Ⅳ诊断标准。结果　MID急性发作期及CI急性期CSF中TNF α、NSE的浓度均非常显著高于Control组 (P <0 .0 1 ) ;MID稳定期及CI恢复期CSF中TNF α的浓度显著高于Control组 (P <0 .0 5) ;MID稳定期CSF中TNF α的浓度同CI恢复期组差异不显著 (P >0 .0 5)。而MID稳定期CSF中NSE浓度低于Control组和CI恢复期组 (P <0 .0 5)。各组CSF中TNF α、NSE的浓度与MMSE评分无显著相关性 (P >0 .0 5)。结论　MID急性发作期与稳定期患者CSF中TNF α、NSE含量呈非一致性变化。MID患者CSF中TNF α、NSE含量变化可能客观地反映患者脑细胞缺血缺氧性损害。但TNF α、NSE含量变化不能直接反应MID患者的智能状态。     

急性脑挫伤患者脑脊液神经元特异性烯醇化酶的变化及意义

目的 :探讨急性脑挫伤患者脑脊液中神经元特异性烯醇化酶 (Neuron -specificenolase,NSE)的变化。方法 :用放射免疫双抗体夹心法对 2 4例广泛脑组织挫伤组 ,30例局部脑挫伤及正常对照组脑脊液NSE含量进行测定。并测定各组冬氨酸转氨酶 (Aspartatetranscarbamoylsse ,AST)水平。结果 :弥漫性脑挫伤患者脑脊液NSE浓度为 (2 5 .43± 5 .6 1)ng/ml,局灶性脑挫伤组为 (14.6 1± 7.5 2 )ng/ml,对照组为 (7.81± 3.2 1)ng/ml,脑挫伤组明显高于对照组 (P <0 .0 5 ) ,且弥漫性脑挫伤组与局灶性脑挫伤组差异显著 (P <0 .0 5 )。脑挫伤组中AST明显高于对照组 ,但AST在广泛脑挫伤组与局部脑挫伤组中无明显差异。结论 :急性脑挫伤患者的NSE、AST水平升高 ,且NSE与脑挫伤体积相关 ,NSE可反映挫伤及其严重程度     

Neuron-specific enolase as an effective immunohistochemical marker for injured axons after fatal brain injury

Recently, it has been reported that a diagnosis of diffuse axonal injury in cases with a short survival period can be made with the use of immunolabelling for β-amyloid precursor protein (APP). We examined whether immunostaining for neuron-specific enolase (NSE) can also be a useful marker for the detection of axonal injury in its early stages. Sections of the corpus callosum from 19 cases of head injury and from 9 cases of no head injury were immunostained for NSE and stained by the standard Holmes’ silver method. For comparison, serial sections from several cases were immunostained for APP. Immunostaining for NSE as well as for APP, labelled injured axons in head injury cases with as early as 1.5 h survival where Holmes’ staining failed to detect any changes of axons. Since NSE and APP labelled only injured axons but not normal axons, the results were readily interpretable. These findings indicate that NSE should be an effective marker for the detection of axonal injury in its early stages. Received: 7 December 1998 / Received in revised form: 11 March 1999     

Immunohistochemical analysis of 61 pituitary adenomas with a monoclonal antibody to the neuron-specific β-tubulin isotype

Pituitary adenomas surgically resected from 61 consecutive patients and 9 normal pituitary glands were studied by immunohistochemistry to determine the localization of the class III-tubulin isotype (neuron-specific) which is recognized by the monoclonal antibody TUJ1. In normal pituitary glands only a few cells were weakly immunopositive for TUJ1, whereas, in 43(73%) of 61 adenomas, more than 5% of tumor cells were immunopositive. The result may indicate that this neuron-specific -tubulin isotype may be either expressed de novo or enhanced under the transformation of pituitary acinar cells to tumors.Research fellow of the Department of Pathology, Kitasato University School of Medicine where the work was conducted     

神经元特异性烯醇化酶与脑损伤

神经元特异性烯醇化酶 ( NSE)为烯醇化酶的γ二聚体同工酶 ,特征性地位于神经元和神经内分泌细胞胞质中 ,血清和脑脊液中亦含有少量 NSE。若神经元发生坏死 ,NSE会漏至胞外 ,使体液浓度升高。在脑损伤性疾病中 ,如脑梗死、脑出血、蛛网膜下腔出血、癫、脑外伤、脑缺氧、脑炎、Creutzfeldt-Jakob病 ,血清和 /或脑脊液 NSE显著升高 ,与脑损伤范围或疾病严重程度密切相关 ,是早期预测预后的重要指标     

流行性乙型脑炎患儿血清及脑脊液中神经元特异性烯醇化酶含量变化与临床关系

分析神经元特异性烯醇化酶 (NSE)含量与流行性乙型脑炎 (乙脑 )患儿脑损伤程度的关系 ;探讨NSE在乙脑发病机制中的作用。方法　采用双抗体夹心法检测NSE含量。结果　乙脑患儿血清及脑脊液中NSE含量在初期即有增高 ,极期达高峰 ,恢复期下降。比较各型乙脑患儿血清及脑脊液中NSE含量 ,显示初期和极期差异有显著统计学意义 (P <0 .0 1 ) ,恢复期差异有统计学意义 (P <0 .0 5 )。结论　NSE含量的测定对乙脑患儿脑损伤程度的判断有重要的参考价值。     

神经元特异性烯醇化酶在颅脑损伤中的意义

目的　探讨血清神经元特异性烯醇化酶 (NSE)与颅脑损伤及其预后之间的关系。方法　用RIA法测定了 70例急性颅脑损伤患者的血清NSE含量 ,结合Glasgow昏迷和预后分级进行比较分析。结果　⑴重型 (a)、轻型 (b)颅脑损伤患者与对照组(c)的血清NSE水平分别为 ( 2 5 8± 10 8)ng/ml、( 19 6± 8 9)ng/ml和 ( 9 5± 2 8)ng/ml ,存在显著性差异 (Pa -b<0 0 5 ,Pa -c<0 0 1,Pb -c<0 0 1) ;⑵死亡植物生存组 (e)、残废组 (f)和恢复良好组 (g)的血清NSE水平分别为 3 1 3± 11 0ng/ml、2 3 0± 8 7ng/ml和 16 3±7 5ng/ml ,两两对比差异明显 (Pe-f<0 0 5 ,Pe -g<0 0 1,Pf-g<0 0 5 ) ;⑶血清NSE≥ 2 2ng/ml组和NSE <2 2ng/ml之间 ,死亡植物生存率、残废率和恢复良好率有显著性差异 ( P <0 0 5 )。结论　伤后早期血清NSE水平在一定意义上反映了脑损害的程度 ;同时在颅脑损伤的预后评估上 ,是较重要的指标之一     

新生儿窒息后血清神经元特异性烯醇化酶与Apgar评分关系分析

目的 :探讨新生儿窒息后血清神经元特异性烯醇化酶 (NSE)浓度与Apgar评分关系。方法 :选择窒息新生儿52例 ,同期健康无窒息对照22例 ,采用免疫放射分析法 (RIA)测定其生后24小时血清NES水平。结果 :(1)1分钟和5分钟Apgar评分时 ,4～7分组与≤3分组之间血清NSE浓度差异均无显著性。 (2)5分钟复苏组、10分钟复苏组、>10分钟复苏组与对照组间血清NSE浓度差异具有统计学意义 (F=6.21,P<0.05)。>10分钟复苏组的血清NSE浓度较10分钟复苏组、5分钟复苏组及对照组明显升高 (P均<0.01)。结论 :新生儿窒息时 ,血清中NSE浓度与Apgar评分关系并非一致 ,而与复苏时间变化一致 ,复苏时间越长 ,NSE升高越明显     

新生儿高胆红素血症血清神经元特异性烯醇化酶及脑干听觉诱发电位变化的临床价值

目的探讨血清神经元特异性烯醇化酶(NSE)及脑干听觉诱发电位(BAEP)在评价新生儿高胆红素血症合并脑组织损伤的临床价值。方法根据血清总胆红素含量不同将90例新生儿高胆红素血症患儿分为A、B两组;40例正常足月新生儿为对照组,分别抽取静脉血行NSE测定和BAEP检测。结果高胆红素血症A、B两组的NSE水平、BAEP异常发生率均明显高于对照组,差异有统计学意义(P<0.01);高胆红素血症A、B两组之间比较,NSE水平及BAEP异常发生率差异也有统计学意义(P<0.01),且TSB水平与NSE水平呈正相关;同时,BAEP异常发生率也增高。结论NSE与BAEP在高胆红素所致神经毒性评价方面均具有较高敏感性,可作为临床监测指标。     

Difference in pathogenesis between herpes simplex virus type 1 encephalitis and tick-borne encephalitis demonstrated by means of cerebrospinal fluid markers of glial and neuronal destruction

We determined the extent of neuronal and glial cell destruction in 13 patients with herpes simplex type 1 (HSV-1) encephalitis, 15 patients with tick-borne encephalitis (TBE), and 20 noninfectious controls by analyzing the cerebrospinal fluid (CSF) concentrations of neurofilament protein (a marker of neurons, mainly axons), neuron-specific enolase (a marker of neurons, mainly somas), glial fibrillary acidic protein, and S-100 protein (markers of astrocytes). In addition, in patients with HSV-1 encephalitis CSF samples were collected serially before 7, 8-14, and 18-49 days and 3-10 months after the onset of neurological symptoms. In the acute stage of HSV-1 encephalitis we found markedly higher CSF levels of the cell damage markers than in patients with TBE. The concentration of cell damage markers in HSV-1 encephalitis decreased within 45 days after acute infection, except for neurofilament protein. The CSF concentrations of neurofilament protein increased during the second week, remained extremely high throughout the next month, and decrease thereafter. The changes in these markers of neuronal and glial destruction demonstrate the neuronal and astroglial cell damage during the first month after HSV-1 encephalitis. In contrast, most patients with TBE had signs only of slight astrogliosis, except for two patients with paresis.