急性颅脑损伤患者血清神经元特异性烯醇化酶、Nogo-A蛋白和髓鞘碱性蛋白水平的变化

目的探讨急性颅脑损伤患者治疗前后血清神经元特异性烯醇化酶（NSE）、Nogo—A蛋白和髓鞘碱性蛋白（MBP）水平的变化。方法选择2012年1月～2013年4月浙江省萧山中医院急性颅脑损伤患者50例（病例组）予以保持呼吸道通畅、吸氧、降颅压、抗感染、营养脑细胞和预防并发症等常规对症治疗，如有手术指征者及时予以手术治疗，治疗时间为2周。另选择同期体检中心体检的正常健康者30名作为对照组。观察治疗前后血清NSE、Nogo—A蛋白和MBP水平的变化。结果病例组患者治疗前血清NSE、Nogo—A蛋白和MBP水平（17．12±6．75）、（201．72±56．27）、（4．79±0．72）μg／L]明显高于对照组（5．24±1．05）、（106．54±31．19）、（1．12±0．24）μg／L]，差异有高度统计学意义（t=5．12、3．10、6．10，P〈0．01）。治疗2周后，患者血清NSE、Nogo—A蛋白和MBP水平（9．12±3．07）、（147．92±40．56）、（2．64±0．92）μ班]较治疗前（17．12±6．75）、（201．72±56．27）、（4．79±0．72）μg／L]均明显下降，差异有统计学意义（t=3．08、2.±31、2．91，P〈0．05或P〈0．01）。结论急性颅脑损伤患者存在血清NSE、Nogo—A蛋白和MBP水平的异常升高，可作为急性颅脑损伤患者早期诊断的敏感指标，其水平的高低可反映脑细胞损伤严重程度。NSE、Nogo—A蛋白和MBP水平的变化可作为急性颅脑损伤患者治疗疗效随访和预后观察的指标。

Level myelin change of serum basic protein from neuron specific enolase, Nogo-a protein and patients with acute craniocerebral injury

Objective To observe the level change of serum neuron specific enolase （NSE）, Nogo-A protein and myelin basic protein （MBP） from patients with acute craniocerebral injury after treatment. Methods 50 patients with acute craniocerebral injury in Xiaoshan Hospital of Traditional Chinese Medicine from January 2012 to April 2013 were selected for the case group, these patients were given the general symptomatic treatments with keeping airway unobstructed, inhaling oxygen, lower-ing the intracranial pressure, anti-infection, nourishing brain cells and prevention of complications, and the patients were giv-en surgery timely if patients had the operation indication, the time of treatments was two weeks. 30 normal healthy people from medical examination center were selected for the control group. The level change of serum NSE, Nogo-A protein and MBP were observed before and after treatments. Results The levels of NSE of （17.12±6.75） μg/L, Nogo-A protein of （201.72± 56.27） μg/L and MBP of （4.79±0.72） μg/L in the case group before treatment were significantly higher than those of NSE of （5.24±1.05） μg/L, Nogo-A protein of （106.54±31.19） μg/L and MBP of （1.12±0.24） μg/L in the control group, the differences were highly statistically significant （P 〈 0.01）. After treatment for two weeks, the levels of NSE of （9.12±3.07） μg/L, Nogo-A protein of （147.92±40.56） μg/L and MBP of （2.64±0.92） μg/L in the case group were significantly lower than those of NSE of （17.12±6.75） μg/L, Nogo-A protein of （201.72±56.27）μg/L and MBP of （4.79±0.72） μg/L in the case group before treat-ments, the differences were highly statistically significant （t = 3.08, 2.31, 2.91, P 〈 0.05 or P 〈 0.01）. Conclusion Abnormal elevation of the levels of serum NSE, Nogo-A protein and MBP can be used as sensitivity index for early diagnosis of acute craniocerebral injury, and changes of these levels can reflect the injury degree of brain cell. The levels of serum NSE, Nogo-A protein and MBP can be used as the index for the chnical follow-up and prognosis of acute craniocerebral injury.