脑卒中患者血清神经元特异性烯醇化酶动态变化及其临床意义

目的 探讨神经元特异性烯醇化酶(NSE)在脑卒中的诊断、观察病情变化和判断预后的价值。方法 采用放射免疫法(RIA)动态检测77例脑卒中患者(脑出血36例、脑梗死41例)的血清NSE。结果 脑梗死和脑出血组血清NSE水平明显高于对照组(P<0.01),发病后48小时内即有升高,第3～4天达到高峰,随后逐渐降低,至28天左右接近正常;发病后各时点脑梗死和脑出血组血清NSE无显著差异(P>0.05);急性期(发病1周内)血清NSE浓度与临床神经功能缺损程度、出血量、梗死灶体积呈正相关(分别P<0.001,P<0.01,P<0.005),与出院时日常生活活动能力(ADL)无相关性(P>0.05)。结论 NSE可作为脑卒中早期诊断、判断病情严重程度的指标之一,但对鉴别诊断及预后的判断无意义。

The dynamic change and its clinical significance of serum neuron-specific enolase in the patients with cerebral stroke

Objective To study the value of the neuron-specific enolase(NSE) in the serum of patients with cerebral stroke in diagnosis, seriousness and evaluation of prognosis. Methods The levels of NSE in the serum of 77 patients with cerebral stroke(36 cases with hemorrhage, 41 cases with infarction) were measured by radio-immunoassay (RIA)method.Results The serum leves of NSE both in cerebral infarction and cerebral hemorrhage patients were obviously higher than those of the control group( P < 0.01) . The NSE levels were higher in 48th hour, highest in 3 ~ 4th days and slowly fell to normal in 28th day. There were no significant differences of NSE contents at every time between infarction and hemorrhage group( P > 0.05). In the first week there was a positive correlation between NSE serum level and neurological deficit scores,the volume of haemorrhage, the volume of infarction( P < 0. 001, P < 0. 01, P < 0.005 respectively) . However, no correlation was found between NSE serum level and clinical outcome ( P > 0.05) . Conclusion The NSE level in serum may be served as a objective index of seriousness and early diagnosis in stroke, but no helpful in differential diagnosis and evaluation of prognosis.