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目的:探讨急性颅脑外伤患者血清神经元特异性烯醇化酶(Neuron-specificenolase,NSE)的含量及动态变化对颅脑损伤的诊断和评估伤情、观察疗效、预后判断的临床价值。方法:采用发光免疫分析,对60例急性颅脑外伤患者及62例正常人血清NSE含量进行同步检测。并于治疗前和治疗后3d、1周、2周、3周NSE的含量进行动态观察。对38例不同预后的急性颅脑外伤患者治疗前后的血清NSE浓度及GCS评分进行回顾分析。结果:急性颅脑外伤患者血清NSE含量显著增高,与正常对照组比较差异具有极显著意义(P<0.001),其NSE增高的程度,重型组>中型组>轻型组(P<0.01),与GCS评分密切负相关(r=-0.9140,P<0.01)。动态观察显示56例不同程度的颅脑外伤患者治疗后血清NSE浓度随着治程的延续而逐渐下降,还发现急性颅脑外伤患者的血清NSE浓度如果高滴度持续增高,则预后不佳,反之则预后相对较好。而且NSE浓度下降越迅速,恢复正常的时间越早,其预后越佳。结论:血清NSE含量反映脑细胞损伤的程度,是一项灵敏的量化指标。进行NSE含量的检测不仅对脑损伤的诊断和评估伤情富有临床价值,而且对于疗效观察及预后的早期判断均有帮助。
Objective: To investigate the content and dynamic changes of serum neuron-specific enolase (NSE) in patients with acute craniocerebral trauma (TBI) in the diagnosis and assessment of traumatic brain injury and to evaluate the clinical efficacy and prognosis. Methods: The levels of serum NSE in 60 acute craniocerebral trauma patients and 62 normal individuals were detected simultaneously by luminescence immunoassay. The levels of NSE in pre-treatment and post-treatment 3d, 1 week, 2 weeks and 3 weeks were observed. 38 patients with different prognosis of acute craniocerebral trauma patients before and after treatment of serum NSE concentration and GCS score were analyzed retrospectively. Results: The serum levels of NSE in patients with acute craniocerebral trauma were significantly higher than those in normal controls (P <0.001). The levels of NSE in severe traumatic brain injury patients were significantly higher than those in severe group (> medium group) and light group (P <0.01) GCS score was negatively correlated (r = -0.9140, P <0.01). Dynamic observation showed that 56 cases of different degrees of traumatic brain injury in patients with serum NSE concentration decreased gradually with the continuation of treatment and found that patients with acute brain injury in serum NSE concentration if the high titer continued to increase, the prognosis is poor, On the contrary, the prognosis is relatively good. And NSE concentration decreased more rapidly, return to normal earlier, the better prognosis. Conclusion: The serum level of NSE reflects the degree of brain cell injury and is a sensitive quantitative indicator. The detection of NSE content not only has clinical value in the diagnosis and assessment of injury of brain injury, but also helps to observe the curative effect and early judgment of prognosis.