脑出血继发癫痫患者血清NSE和炎症细胞因子浓度测定对病情的预测价值

目的:探讨脑出血急性期继发癫痫患者血清NSE,炎症细胞因子的变化及对病情的预测价值。方法:检测脑出血继发癫痫组,单纯脑出血组和健康对照组各31例对象的血清肿瘤坏死因子(TNF-α),白介素-β(IL-1β),白介素-6(IL-6),C-反应蛋白(CRP)与神经元特异性烯醇化酶(NSE)的含量,并同步采用美国卫生研究院卒中量表(NIHSS)进行评分。结果:组间脑出血继发癫痫组和单纯脑出血组患者各指标水平均高于健康对照组,(P<0.001),有非常显著差异。多元回归分析显示炎症细胞因子的变化与NSE及NIHSS有线性关系,NSE是NIHSS的独立预测因子。结论:脑出血急性期继发癫痫的病理机制是炎症细胞因子进一步表达导致神经元再次受损,NSE升高,检测血清中NSE浓度对患者的病情预测有重要意义。

The Serum Levels of Neuron-specific Enolase(NSE) and Inflammatory Cytokines in Acute Intracerebral Hemorrhage Secondary Epilepsy Patients by for Indicating Prognosis.

Objective:To explore the changes of serum levels of NSE and inflammatory cytokines in acute intracerebral hemorrhage secondary epilepsy patients,and to find the relationship between these changes and the prognosis.Methods:serum levels of tumor necrosis factor(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),C-reactive protein(CRP)and neuron-specific enolase(NSE)were measured in 31 patients with intracerebral hemorrhage secondary epilepsy,31 patients with purely intracerebral hemorrhage and 31 healthy people.At the same time all above people were evaluated by National Institute of Health Stroke Scale(NIHSS).Results:Intergroup t-test showed that all indicators(TNF-α,IL-1β,IL-6,CRP and NSE)in intracerebral hemorrhage secondary epilepsy group and the pure intracerebral hemorrhage group were significantly higher than those in healthy control group(P<0.0001 and 0.001).Multiple regression analysis showed that inflammatory cytokines and NIHSS and NSE had linear relationship,NSE was an independent predictor factor of NIHSS.Conclusions:The pathological mechanism of acute intracerebral hemorrhage secondary epilepsy is further expression of inflammatory cytokines leading to further damage to neuron and NSE increased.Serum NSE concentration has the important significance for prognosis.