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目的探讨急性脑挫伤患者血清神经元特异性烯醇化酶(NSE)在急性期的动态变化及其临床意义。方法选择28例急性脑挫伤患者,脑外伤按严重程度分为弥漫性脑挫伤组13例,局灶性脑挫伤组15例。分时抽取外周静脉血,用放射免疫法(RIA)检测急性期NSE血清水平,观察NSE与出血量和神经功能缺损的相关性。另取15位健康人作为正常对照组。结果弥漫性脑挫伤患者早期血清NSE浓度为(75．43±5．61)μg/ml,局灶性脑挫伤组为(34．61±7．52)μg/ml,对照组为(10．8l±3．21)μg/ml,脑挫伤组明显高于对照组(P＜0．05),且弥漫性脑挫伤组与局灶性脑挫伤组差异有显著性(P＜0．05)。弥漫性脑挫伤组与局灶性脑挫伤组血清NSE水平均于第3天达到高峰,随后开始下降。血清NSE水平与患者神经功能缺损程度评分之间呈正相关,与预后呈负相关。结论神经元特异性烯醇化酶可以作为判断脑挫伤急性期病情严重程度和评估预后的指标之一。
Objective To investigate the dynamic changes of serum neuron specific enolase (NSE) in acute brain contusion and its clinical significance. Methods Twenty-eight patients with acute cerebral contusion were selected. According to the severity, traumatic brain injury was divided into diffuse cerebral contusion group (n = 13) and focal cerebral contusion group (n = 15). Peripheral venous blood samples were taken at different time points, and serum levels of NSE in acute phase were detected by radioimmunoassay (RIA). The correlation between NSE and hemorrhage volume and neurological deficit was observed. Another 15 healthy people as a normal control group. Results The serum levels of NSE in patients with diffuse brain contusion were (75.43 ± 5.61) μg / ml and (34.61 ± 7.52) μg / ml, respectively, and those in the control group were (10. 8l ± 3.21) μg / ml in the contusion group was significantly higher than that in the control group (P <0.05), and there was a significant difference between the contusion group and the diffuse brain contusion group (P <0.05) . Serum NSE levels in diffuse brain contusion group and focal contusion group peaked on the third day, and then began to decrease. There was a positive correlation between serum NSE level and score of neurological deficit in patients and negative correlation with prognosis. Conclusion Neuron-specific enolase can be used as one of the indicators to judge the severity of the brain contusion in the acute stage and assess the prognosis.