脑脊液NSE水平与弥漫性轴索损伤严重程度及患者预后的关系

目的观察弥漫性轴索损伤(DAI)患者脑脊液中神经元特异性烯醇化酶(NSE)水平变化,并探讨其与损伤程度及患者预后的关系。方法用放射免疫分析检测79例DAI患者伤后12h、1d、2d、3d、7d和14d的脑脊液NSE水平,并分析其与颅脑损伤严重程度及患者预后的关系。15例非神经系统疾病患者为对照组。结果伤后12hDAI患者脑脊液NSE水平明显高于对照组(P<0.01)。重型组脑脊液NSE水平明显高于轻、中型组(P<0.01);预后不良组的脑脊液NSE水平则明显高于预后良好组(P<0.01或P<0.05);死亡组病人NSE水平持续增高。结论检测脑脊液NSE水平变化不但有助于评估DAI严重程度,而且有助于判断其预后。

Relationship of neuron-specific enolase level in cerebrospinal fluid with injury severity and prognosis in patients with diffuse axonal injury

Objective To investigate the relationship levels of neuron-specific enolase（NES）in cerebrospinal fluid（CSF）withi njury severity and prognosis in patients with diffuse axonal injury（DAI）.Methods The levels of NSE in CSF were measured byr adioimmunoassay（RIA）12 hours and 1,2,3,7 and 14 days after DAI in 79 patients with DAI.The relationship of NSE level with thes everity of DAI and the prognosis was analyzed in the patients with DAI.Another 15 subjects without the nervous system disease serveda s control group.Results The level of NSE in CSF was significantly higher in the patients with DAI 12 hours and 1,2,3 and 7 days aftert he injury than that in the control group（P0.01）.The level of NSE in CSF was significantly higher in the severe injury group than that int he moderate or mild injury group 12 hours and 1,2,3 and 7 days after the injury（P0.01）.The level of NSE in CSF was significantlyh igher in the patients with poor prognoses than that in the patients with good prognoses 12 hours and 1,2,3 and 7 days after the injury（ P0.01 or P0.05）.Persistent high NSE level in CSF were found after the injury in dead group.Conclusion The levels of NSE in CSFm ay be helpful to assessing the severity of DAI and predicting the prognosis of patients with DAI.