血清神经元特异性烯醇化酶在脑梗死患者中含量的变化及其临床意义

目的分析脑梗死（cerebral infarction,CI）患者血清中神经元特异性烯醇化酶（serum neuron specific enolase,NSE）的波动及其临床意义。方法选取2013-02/2013-11月在广医三院神经内科住院的、发病〈72 h的脑梗死患者60例,测量其72 h、第7 d、第14 d的NSE,按牛津郡社区卒中项目（Oxford community stroke project,OCSP）分型以及美国国立卫生研究院卒中量表（National Institute of Health Stroke Scale,NIHSS）评分,对不同亚型、不同病情严重程度的患者血清NSE含量以及患者不同时间的NSE进行比较,并分析其变化与病情发生发展的关系。结果完全前循环梗死（total anterior circulation infarction,TACI）组血清中的NSE含量明显高于对照组以及其余3组,且差异有统计学意义（P〈0.01）;部分前循环梗死（partial anterior circulation infarction,PACI）组以及后循环梗死（posterior circulation infarction,POCI）组较对照组以及腔隙性梗死（lacunar infarction,LACI）组明显升高,差异有统计学意义（P〈0.05）;而LACI组的NSE含量与对照组相比无明显差异无统计学意义（P〉0.05）。患者的血清NSE高峰值在发病72 h后,发病第7 d后较前有所下降时较前有所下降。血清NSE含量与NIHSS评分呈正相关关系,重型患者血清的NSE含量明显高于病情中型组,中型组较对照组以及轻型组明显升高,以上数据组间相比差异均有统计学意义（P〈0.01）。结论 CI患者血清NSE含量可对病灶大小以及病情的严重程度给出一定的参考价值,从而有助于为临床诊治提供依据。

Changes and Clinical Significance of Serum Neuron Specific Enolase in Patients with Cerebral Infarction

Objective To investigate the changes and clinical significance of serum neuron specific enolase （NSE） in patients with cerebral infarction.Methods Sixty cerebral infarction patients between February 2013 and November 2013 at the authors＂ department with the disease on set 〈72 h were studied. The serum specimens were gathered on admission at 72 h, 7th and 14th day after onset. The serum NSE levels of different subtypes, different severity and at different times were compared according to Oxford community stroke project （OCSP） and the score of National Institute of Health Stroke Scale （NIHSS） . The relationships between serum levels of NSE and patients＇ condition and prognosis of disease were analyzed.Results Serum levels of NSE in total anterior circulation infarction （TACI） group was significantly higher than those in control group and other 3 subtype groups. Serum levels of NSE in partial anterior circulation infarct （PACI） group and posterior circulation infarction （POCI） group were higher than those in LACI group and control group （P〈 0.05） .There was no significant difference between lacunar infarction （LACI） group and control group （P〉0.05） .Serum levels of NSE reached the peak on 72h after onset, and decreased on the 7th day. The serum levels of NSE was related with score of NIHSS. The serum levels of NSE in high score group was higher than those in the middle score group. The middle score group was significantly higher than the low score group and the control group （P〈0.01） .Conclusion Serum levels of NSE may indicate the size of lesions and severity of disease, and provide the basis for guiding the clinical diagnosis and treatment.