脑梗死患者血浆神经元特异性烯醇酶的动态变化及其与病情预后的关系

目的　探讨急性脑梗死患者血浆神经元特异性烯醇酶 (neuronspecificenolase ,NSE)的动态变化及其与预后的关系。方法　选择急性脑梗死患者 6 8例 ,分别于发病后 3d以内 (6 8例 )、第 7天 (6 6例 )、第14天 (6 5例 )、第 30天 (6 4例 )采集血标本 ,应用酶联免疫吸附法测定血浆NSE水平 ,检测结果与 35例正常对照组比较 ,探讨脑梗死患者血浆NSE水平与脑梗死体积及临床神经功能改善的相关性。结果　脑梗死患者发病 3天内、第 7天血浆NSE水平明显高于对照组 ,以 3天内变化最显著 (t值分别为 11 2 9,6 5 4 ;P <0 0 0 1) ;预后不良组血浆NSE水平在 3d内 (12例 )、第 7天 (10例 )、第 14天 (9例 )各时间点均明显高于预后良好组 (5 6例 ) (t值分别为 5 99,3 5 8,2 2 6 ;P <0 0 5 )。 6 6例脑梗死患者第 7天的脑梗死体积与其发病 3d以内、第 7天血浆NSE水平呈正相关 ,相关系数分别为 0 83、 0 75 (P<0 0 0 1)。 6 4例脑梗死患者第 30天神经功能缺损评分减少值与 3天以内、第 7天血浆NSE水平呈负相关 ,相关系数分别为 - 0 4 1(P <0 0 1)、 - 0 37(P <0 0 1)。结论　急性脑梗死患者早期血浆NSE水平明显升高 ,血浆NSE的动态变化可以反映脑梗死的严重程度及其近期预后

Dynamic changes of plasma level of neuron-specific enolase in patients with cerebral infarction and its significance for prognosis

Objective To investigate the dynamic change of plasma neuron-specific enolase(NSE) level in patients with cerebral infarction(CI) and its significance for prognosis.Methods 68 patients with CI were recruited into this study. The concentrations of NSE in patients were measured by ELISA at 3 days(68 cases),7 days(66 cases),14 days(65 cases) and 30 days(64 cases) after onset. The relationships between plasma NSE level and infarction area, plasma NSE level and neurological function impairment were explored.Results As compared with the controls (35 cases), plasma NSE level in patients with CI were significantly increased at 3 days and 7 days, especially at 3 days(t=11.29, 6.54; P<0.001). Patients with bad prognosis had higher levels of plasma NSE than those with good prognosis at 3 days,7 days and 14 days(t=5.99, 3.58, 2.26; P<0.001, 0.001, 0.05,respectively). There was a positive correlation between infarction area and plasma NSE level at 3 days and 7 days (r=0.83 or 0.75; P<0.001).The decreased clinical neurological deficit scores were negatively correlated with plasma NSE level at 3 days and 7 days(r=-0.41, -0.37;P<0.001, 0.01). Conclusion Plasma NSE level is increased at early stage of CI.Dynamic changes of plasma NSE level might reflect the degrees of cerebral infarction and short-term prognosis of patients with CI in the hear future.