心型脂肪酸结合蛋白、神经元特异性烯醇化酶与急性脑梗死病情转归及预后评估的相关性

目的 探讨心型脂肪酸结合蛋白(heart acid binding protein,H-FABP)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)在急性脑梗死(ACI)患者(发病时间<24小时)病情转归及预后评估中的作用。方法 选取ACI患者109例作为观察组,并根据神经功能缺损程度分为轻、中、重3个亚组,选择同期短暂性脑缺血发作(TIA)病例80例作为对照组,分别在治疗前后检查血清H-FABP及NSE,进行NIHSS评分、测量梗死体积。比较两组治疗前后血清H-FABP、NSE差异,观察ACI组血清H-FABP、NSE与脑梗死体积、NIHSS评分的关系。结果 ①ACI组、TIA组血清H-FABP、NSE明显高于正常值(P<0.01);②治疗前ACI组血清H-FABP高于TIA组,差异具有统计学意义(P<0.01);③ACI组轻、中、重3个亚组血清H-FABP随着病情程度加重而升高(P<0.01);④ACI组血清H-FABP与NIHSS评分、梗死体积呈显著正相关(r_s=0.338、0.246,P<0.01),血清NSE与梗死体积呈正相关(r_s=0.203,P<0.05);梗死体积与治疗前NIHSS评分呈正相关(r_s=0.265,P<0.01);⑤治疗后ACI组血清H-FABP、NSE较治疗前降低(P<0.05,P<0.01);治疗前后血清H-FABP、NSE的差值与NIHSS评分差值呈正相关(r_s=0.665、0.512,P<0.01)。结论 ACI患者血清H-FABP、NSE异常升高,并与神经损伤程度及预后呈显著正相关,可作为ACI病情转归及预后评估的敏感指标。

Heart type fatty acid binding protein and neuron specific enolization enzyme for early diagnosis and prognosis evaluation in acute cerebral infarction

Objective To explore early diagnosis and prognosis evaluation in acute cerebral infarction (onset < 24 h) using the heart acid binding protein (H-FABP) accompanied with neuron-specific enolase (NSE).Methods 109 patients with acute cerebral infarction (ACI group) were selected as experimental group. Then, the patients were divided into three subgroups(light, medium, heavy) according to the defect degree of nerve function. 80 patients with transient ischemic attack (TIA group) were selected as control group. H-FABP and NSE in serum, NIHSS score and volume of nidus were tested before and after treatment. The difference of H-FABP and NSE in serum before and after treatment were compared, and the relationships between H-FABP, NSE and NIHSS score and volume of nidus were explored.Results ①The serum H-FABP and NSE of ACI group were obviously higher than normal values(P<0.01). ②The H-FABP of ACI group was higher than that of TIA group (P<0.01). ③The serum H-FABP of the three subgroups from ACI group rose as the disease aggravated (P<0.01). ④The serum H-FABP of ACI group was positive related to NIHSS score and infarct volume(r_s=0.338,0.246,P<0.01). The serum NSE was positive related to infarct volume (r_s=0.203,P<0.05). The infarct volume was positive related to NIHSS score (r_s=0.265,P<0.01). ⑤The serum H-FABP and NSE of ACI group decreased after treatment as comparing with before treatment(P<0.05,P<0.01). The different values of serum H-FABP and NSE were positive related to different values of NIHSS score before and after treatment (r_s=0.665,0.512,P<0.01).Conclusion The serum H-FABP and NSE would rise abnormally in ACI patients and were positively related to nerve damage and the degree of prognosis. Both indexes can be used as sensitive indicators for disease outcome and prognosis evaluation.