血清神经元特异性烯醇化酶评估急性脑梗死患者病情严重程度及短期预后的意义

doi:10.20047/j.issn1673-7210.2023.08.18

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摘要目的探讨血清神经元特异烯醇化酶（NSE）评估急性脑梗死患者病情严重程度及短期预后的意义。方法选择2019年1月至2020年4月上海交通大学医学院附属仁济医院宝山分院（以下简称“我院”）神经内科126例诊断为急性脑梗死的患者作为急性脑梗死组，另选取同期我院健康体检者55名为对照组。比较急性脑梗死组与对照组临床资料的差异。急性脑梗死组根据美国国立卫生院卒中量表（NIHSS）评分评估病情严重程度，分为轻型（46例）、中型（47例）、重型（33例），再根据出院时神经功能缺损程度评分将其分为显著进步（41例）、进步（40例）、无变化（45例），比较不同病情严重程度和短期预后患者血清NSE水平的差异，分析NSE水平与急性脑梗死组NIHSS、神经功能缺损评分的相关性。评估NSE判断急性脑梗死患者病情程度及短期预后的受试者操作特征曲线下面积（AUC）、最佳临界值、敏感性及特异性。结果急性脑梗死组NSE水平高于对照组，差异有统计学意义（P＜0.05）。轻、中、重型患者NSE水平逐渐升高，显著进步、进步、无变化患者NSE水平逐渐升高，差异有统计学意义（P＜0.05）。急性脑梗死组NSE水平与NIHSS评分呈正相关（r＞0，P＜0.05），与神经功能缺损评分呈负相关（r＜0，P＜0.05）。血清NSE水平对急性脑梗死患者病情严重程度及短期临床预后均有一定的预测价值（AUC＞0.5，P＜0.5）。结论血清NSE水平对急性脑梗死患者中枢神经损伤的严重程度及患者的短期临床预后具有判断价值，可作为急性脑梗死严重程度及短期临床预后评估提供可靠的生物学标志物。

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	朱健1 蔡坚2 杨谨1 赵佩1 朱德生2

关键词 ：急性脑梗死, 神经元特异烯醇化酶, 严重程度, 短期预后

Abstract：Objective To investigate the significance of serum neuron-specific enolase (NSE) in evaluating the severity and short-term prognosis of acute cerebral infarction patients. Methods A total of 126 patients diagnosed with acute cerebral infarction in the Department of Neurology, Baoshan Branch, Renji Hospital, Shanghai Jiao Tong University School of Medicine (hereinafter referred to as “our hospital”) from January 2019 to April 2020 were selected as the acute cerebral infarction group, and 55 physical healthy subjects in our hospital during the same period were selected as the control group. The clinical data of acute cerebral infarction group and control group were compared. The acute cerebral infarction group was classified as mild (46 cases), medium (47 cases), and severe (33 cases) according to the score of the National Institutes of Health stroke scale (NIHSS). Then, according to the degree of neurological impairment at discharge, the patients were divided into significant improvement (41 cases), improvement (40 cases), and no change (45 cases). The difference of serum NSE level in patients with different severity and short-term prognosis was compared, and the correlation between NSE level and the score of NIHSS, the neurological deficit in acute cerebral infarction group was analyzed. The area under the receiver operating characteristic curve (AUC), optimal critical value, sensitivity, and specificity of NSE in determining the severity and short-term prognosis of patients with acute cerebral infarction were evaluated. Results The level of NSE in acute cerebral infarction group was higher than that in control group, and the difference was statistically significant (P＜0.05). The level of NSE in mild, moderate, and severe patients was increased gradually, and the level of NSE in patients with significant improvement, improvement, and no change was increased gradually, the differences were statistically significant (P＜0.05). The level of NSE in acute cerebral infarction group was positively correlated with NIHSS score (r＞0, P＜0.05), and negatively correlated with the score of neurological deficit (r＜0, P＜0.05). Serum NSE level had a certain value in predicting the severity and short-term prognosis of patients with acute cerebral infarction (AUC＞0.5, P＜0.5). Conclusion Serum NSE level is valuable for evaluating the severity of central nervous system injury and short-term clinical prognosis of patients with acute cerebral infarction, and can be used as a reliable biomarker for evaluating the severity of acute cerebral infarction and short-term clinical prognosis.

Key words： Acute cerebral infarction Neuron-specific enolase Severity Short-term prognosis

基金资助:上海市卫生健康委员会科研项目（202040371）；
上海交通大学医学院附属仁济医院宝山分院医学重点专科建设项目支撑课题（RBZDZK-2019-001）。

通讯作者: 朱德生（1977.2-），男，博士，副主任医师，主要从事脑血管病临床与基础研究工作。

作者简介: 朱健（1977.2-），男，硕士，副主任医师，主要从事脑血管病研究工作。

引用本文:

朱健1 蔡坚2 杨谨1 赵佩1 朱德生2. 血清神经元特异性烯醇化酶评估急性脑梗死患者病情严重程度及短期预后的意义[J]. 中国医药导报, 2023, 20(8): 83-86.
ZHU Jian1 CAI Jian2 YANG Jin1 ZHAO Pei1 ZHU Desheng2. Significance of serum neuron-specific enolase in evaluating severity and short-term prognosis of patients with acute cerebral infarction. 中国医药导报, 2023, 20(8): 83-86.

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https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.08.18 或 https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I8/83

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