NSE、MBP对重型脑外伤的临床评估

目的　研究重型脑外伤后神经元特异性烯醇化酶 (neuron specific enolase,NSE)、碱性髓鞘蛋白 (myelinbasic protein,MBP)血清浓度变化 ,以期为临床重型脑外伤后脑损伤监测及预后评估提供直观的定量指标。方法　对 3 0例重型脑外伤住院患者伤后 1 2 h至第 4天进行连续血清 NSE、MBP浓度检测 ,并结合格拉斯哥预后计分 (GOS)及头颅 CT表现进行比较分析。结果　 3 0例重型脑外伤患者伤后 1 2 h血清 NSE、MBP均显著高于正常对照组 ,且与患者预后密切相关。此后 NSE、MBP浓度虽均呈下降趋势 ,但仍高于正常值 ,预后恶劣组伤后每天 NSE浓度均持续高于预后良好组 ,差异有显著性。结论　重型脑外伤后血清标记物 NSE、MBP浓度与患者预后关系密切 ,且伤后 NSE浓度动态变化对继发性脑损害评估亦有重要意义 ,其为临床救治效果及病情转归的判断提供了有效手段。

Evaluation of NSE and MBP Tests in Patients with Severe Head Injury

Objective To evaluate the test of NSE and MBP in monitoring and prognosisaftersevere head injury. Methods 30 patients with severe head injury were involved in this study, ranging from 26 to 64 years old. Serial concentrations of NSE and MBP in serum were measured in all cases from Day 1 to Day 4 after head injury. And prognosis of all patients were evaluated by GOS. Results The concentrations of NSE and MBP in serum of both groups 12 hours after head injury were higher than normal group and had a close relationship with the prognosis. Afterwards, the value of NSE and MBP decreased in following days, but there was still a significant difference of NSE between the group with poor and satisfying outcome, whereas no such difference was found in MBP. Conclusions The findings suggest that NSE and MBP maybe a promising predictor for assessing the prognosis after severe head injury.