急性脑梗死患者血浆神经元特异性烯醇酶和碱性髓鞘蛋白的动态变化及意义

目的 探讨急性脑梗死患者血浆神经元特异性烯醇酶(NSE)和碱性髓鞘蛋白(MBP)的动态变化及其对预后的影响.方法 选择急性脑梗死患者75例,分别于发病24 h、第4天、第7天、第14天采集血标本,应用酶联免疫吸附法测血浆NSE、MBP水平,并与正常对照组40例进行比较.结果 脑梗死患者发病24 h、第4天血浆NSE、MBP明显高于对照组,以24 h为主,预后不良组血浆NSE水平在发病24 h、第4天、第7天各时间点均明显高于预后良好组,而预后不良组血浆MBP水平发病在24 h、第4天各时问点亦高于预后良好组.73例脑梗死患者发病第4天的梗死体积与发病24 h、第4天血浆NSE、MBP水平呈正相关.相关系数分别为0.92、0.78(均P＜0.001)及0.82、0.69(均P＜0.001).72例脑梗死患者第14天神经功能缺损评分减少值与发病24 h、第4天的血浆NSE、MBP水平呈负相关,相关系数分别为-0.51、-0.45(均P＜0.001)及-0.47、-0.36(P＜0.001和0.01).结论 急性脑梗死患者早期血策NSE、MBP水平升高明显,血浆NSE、MBP的动:态变化可反映脑梗死的严重程度及预后.

The dynamic changes of the plasma neuron-specific enolase and myelin basic protein levels and their significance in patients with acute cerebral infarction

Objective To investigate the dynamic changes of the plasma neuron-specific enolaee(NSE) and myelin basic protein(MBP)levels and their slgaificance for prognosis in patients with cerebral infarction(CI).Methods The concentrations of NSE and MBP in 75 patients with CI were measured by EUsA within the 24 hours,on the 4th day,on the 7th day and 14th days after the onset,respectively.The results were compared with 40 healthy controls.The correlation among the plasma NSE,MBP level,and the size of the infarction and the neurological function in the patients were explored.Results Compared with those of 40 healthy controls,plasma NSE、MBP levels of the pailents were increazed significantly within the 24 hours and on the 4th day,and especially within the 24 hours.The patients with poor prognosis had higher levels of plasma NSE,MBP within the 24 hours,on the 4th days and on the 7th days than those with good prognosis.There was a positive correlation between the size of the infarction and plasma NSE、MBP levels within the 24 hours and on the 4th days,with the correhtion coefficients of 0.92,0.78(P＜0.001)and 0.82,0.69(P＜0.001)respectively.The decreased clinical neurological deficit scores on the 14th day after the attack were negatively correlated with plasma NSE、MBP levels within the 24 hours and on the 4th day,with the correlation coefficients of-0.51,-0.45(P＜0.001)and-0.47,-0.36(P＜0.001 and 0.01)respectively.Conclusion The plasma levels of NsE and MBP increase obviously in the early stage of the CI.The dynamic changes of the plasma NSE and MBP levels in the patients with CI might reflect to some extent the severity of the neuronal damages and the short-term outcome.