腹部创伤早期脑组织及血清神经元特异性烯醇化酶的改变

目的观察腹部爆炸伤后早期脑组织、血清神经元特异性烯醇化酶(neuron-specificenolase,NSE)的变化规律,以探讨血清NSE对这种间接性脑损伤的早期诊断价值。方法健康雄性杂种犬22只,随机分为正常对照组5只,致伤组17只。制作犬腹部爆炸伤动物模型。伤后测定不同时相点血清神经元特异性烯醇化酶浓度,并于相应时相点观察皮层神经元NSE免疫组织化学反应强度及反应阳性细胞数目的变化。结果伤后即刻血清NSE水平达11.6μg/L,显著高于伤前8.2μg/L(F=26.29,P<0.01),伤后1.5h达峰值16.9μg/L,12h以后迅速下降,到伤后24h为9.6μg/L,基本接近伤前水平(P>0.05)。皮层神经元NSE免疫组织化学反应强度伤后即刻为164灰度级,明显低于正常对照组178灰度级(F=10.37,P<0.01),且持续下降,伤后24h为161灰度级,仍显著低于正常对照组(F=45.23,P<0.01)。正常皮层NSE免疫组织化学染色阳性细胞计数为43个,伤后6h下降为35个,两者相差显著(F=6.99,P<0.01),伤后24h为29个,与正常对照组比相差仍然显著(F=20.90,P<0.01)。结论血清NSE水平的检测可作为腹部爆炸伤后脑损伤的早期诊断指标之一。

Early changes of neuron-specific enolase in serum and brain tissue after explosive abdomen wounds in dogs

AIM:To observe early changes of neuron- specific enolase(NSE) in serum and brain tissue after explosive abdomen wounds so as to provide useful parameter for early diagnosis. METHODS:Twenty two healthy male hybridized dogs were divided randomly into control group(n=5) and injury group(n=17).Dog model of explosive abdomen injury was established.Levels of neuron specific enolase(NSE) in the serum were determined at different phases. Meanwhile, the numbers of NSE immunohistochemical reactive positive cells and the reactive intensity in the cortex were observed. RESULTS:NSE level reached 11.6 μ g/L at instant time after injury which was significantly higher than pre injury ( F=26.29, P< 0.01) , and reached the peak at 1.5 hour after injury.Then,the level of serum NSE began to drop dramatically from 12 hours after injury and almost reached the preinjury level(9.6 μ g/L).The intensity of NSE immunohistochemical reaction in the cortex(164 gray grade) at instant time after injury was significantly decreased than control group( 178 gray grade,F=10.37,P< 0.01) ,and decreased continuously.The gray grade at 24h after injury was 161 which was also lower than control group( F=45.23,P< 0.01) .The numbers of NSE positive cells in the cortex(35) were obviously decreased till 6 hours after injury ( F=6.99,P< 0.01) , and kept this tendency to 24 hours after injury(29)(F=20.90,P< 0.01). CONCLUSION:Serum -NSE may used as a marker for early diagnosis of indirect brain injury caused by explosive abdomen injury.