高血压性基底节区脑出血患者血清S100钙结合蛋白B、神经特异性烯醇化酶水平对病情的评估及预后的预测价值

目的探讨高血压性基底节区脑出血患者血清S100钙结合蛋白B(S100B)、神经特异性烯醇化酶(NSE)水平对病情评估及预后的预测价值。方法检测60例高血压性基底节区脑出血患者及30名正常对照者的血清S100B、NSE水平。于脑出血后3个月采用m RS评分评价患者的预后。结果脑出血组及脑出血轻度、中度、重度亚组患者各时间点间血清S100B及NSE水平差异有统计学意义(均P<0.05)。LSD多重比较显示,脑出血组及脑出血轻度、中度、重度亚组间各时间点血清S100B及NSE水平差异有统计学意义(均P<0.05)。脑出血组轻度、中度、重度亚组及正常对照组间第1 d、第7 d血清S100B(F=350.425,F=109.170;均P<0.05)及NSE水平(F=103.296,F=63.300;均P<0.05)差异有统计学意义,第90 d差异无统计学意义(F=0.347,P=0.791;F=1.470,P=0.233)。与正常对照组比较,脑出血组及脑出血轻度、中度、重度亚组第1 d、第7 d血清S100B及NSE水平差异有统计学意义(均P>0.05),第90 d差异无统计学意义(均P>0.05)。LSD多重比较分析显示,脑出血轻度亚组与中度、重度亚组及正常对照组第1 d、第7 d血清S100B及NSE差异有统计学意义(均P<0.05),第90 d差异无统计学意义(均P>0.05)。入院第1 d血清S100B及NES水平与颅内血肿量呈正相关(r=0.818,r=0.619;均P<0.01)。与预后不良亚组比较,预后良好亚组第1 d血清S100B及NSE水平显著降低(P=0.041,P=0.018),两组间第7 d及第90 d血清S100B(P=0.101,P=0.468)及NSE(P=0.077,P=0.980)差异无统计学意义。破入脑室亚组患者第1 d及第7 d血清S100B、NSE水平显著明显高于未破入脑室组(均P<0.05),两组第90 d血清S100B、NSE水平差异无统计学意义(均P>0.05)。结论血清S100B、NSE水平可以反映脑损伤的严重程度、预测颅内血肿量,对急性期高血压性基底节区脑出血患者的病情及预后方面具有一定的评估、预测价值。

Evaluation and prognostic value of serum S100 calc-binding protein B and neuro-specific enolase levels in patients with hypertensive basal ganglia cerebral hemorrhage

Objective To investigate the evaluation and prognostic value of serum S100 calc-binding protein B(S100B)and neuro-specific enolase(NSE)levels in hypertensive patients with cerebral hemorrhage in basal ganglia region.Methods Serum S100B and NSE levels in 60 patients with hypertensive basal ganglia cerebral hemorrhage and 30 normal controls were detected.The m RS score was used to evaluate the prognosis of patients 3 months after intracerebral hemorrhage.Results There were statistically significant differences in serum S100B and NSE levels in cerebral hemorrhage group and the mild,moderate and severe subgroups between the different time points(all P<0.05).LSD multiple comparison showed that the serum S100B and NSE levels in the cerebral hemorrhage group and the mild,moderate and severe cerebral hemorrhage subgroups were compared in pairs at different time points,and the difference were statistically significant(all P<0.05).The difference of serum S100B(F=350.425,F=109.170;all P<0.05)and NSE levels(F=103.296,F=63.300;all P<0.05)at 1 st day and 7 th day between mild,moderate,severe cerebral hemorrhage subgroup and normal control group were statistically significant,while the difference at 90 th day was not statistically significant(F=0.347,P=0.791;F=1.470,P=0.233).Compared with those in normal control group,the S100B and NSE levels at 1 st day and 7 th day in cerebral hemorrhage group and the mild,moderate,severe subgroups were statistically significant(all P>0.05),while the differences at90 th day were not statistically significant(all P>0.05).LSD multiple comparison showed that there were significant differences in serum S100B and NSE levels at 1 st day and 7 th day between mild subgroup and moderate and severe subgroup of cerebral hemorrhage and normal control group(all P<0.05),while no significant differences at 90 th day(all P>0.05).The serum S100B and NES levels at 1 st day were positively correlated with amount of intracranial hematoma(r=0.818,r=0.619;all P<0.01).Compared with those in poor prognosis subgroup,the serum S100B and NSE levels at 1 st day of good prognosis subgroup were significantly decreased(P=0.041,P=0.018),and there was no significant difference between the two groups in serum S100B(P=0.101,P=0.468)and NSE(P=0.077,P=0.980)at 7 th and 90 th day.The serum S100B and NSE levels at 1 st day and 7 th day of the patients in ventricular rupture subgroup were significantly higher than those in without ventricular rupture subgroup(all P<0.05),and there was no statistically significant difference in the serum S100B and NSE levels at 90 th day between the two groups(all P>0.05).Conclusion Serum S100B and NSE levels can reflect the severity of brain injury and predict the amount of intracranial hematoma,and have certain evaluation and prediction value for the condition and prognosis of patients with acute hypertensive basal ganglia hemorrhage.