【摘要】 目的:研究重型脑损伤后血清神经特异性烯醇化酶(NSE),碱性髓鞘蛋白(MBP)浓度在预后的早期评估中的价值。方法:对2002-01/2002-12间40例重型脑损伤住院患者在伤后12h内进行血清NSE,MBP浓度检测,并结合格拉斯哥结局量表(GOS)评分进行比较分析。结果:40例重型脑损伤患者伤后血清NSE,MBP浓度均显著高于正常对照组,不同预后组之间NSE,MBP浓度存在显著差异。以伤后12h血清NSE浓度30mg/L,MBP10mg/L浓度为分界标准评估预后,NSE评估预后的特异度为77%,敏感度67%;MBP特异度为64%,敏感度61%。ROC曲线(受试者工作特性曲线)则显示NSE对预后的评估较MBP更敏感更特异。结论:伤后血清NSE,MBP浓度对评估预后具有较高的特异性和敏感性。而NSE浓度在预后评估中的作用较MBP更为敏感、特异,因此可作为评估重型脑损伤预后的一种可靠的临床方法。更多还原

【Abstract】 AIM:To explore the value of the concentrations of serum neuron specific enolase(NSE) and myelin basic protein(MBP) in predicting the prognosis of patients with severe brain injury. METHODS:Forty patients with severe brain injury, who were in hospital during 2002 01 to 2002 12, were involved in this study. The concentrations of NSE and MBP in serum were measured within 12 hours after brain injury and were combined with the score of Glasgow Outcome Scale(GOS) for comparative analysis. RESULTS:The concentrations of NSE and MBP in serum of the 40 patients were significantly higher than those in the normal control group, there were significant differences in the concentrations of NSE and MBP among different prognosis groups. The prognosis were evaluated according to the delimitation standard of 12 h after injury(the concentration of NSE and MBP were 30 mg/L and 10 mg/L, respectively), the specificity and sensitivity of NSE were 77%and 67%, and those of MBP were 64%and 61%. the ROC curves of NSE and MBP showed that NSE had a better value in predicting outcomes than MBP. CONCLUSION:NSE and MBP play an important role in predicting prognosis, but NSE is a more promising outcome predictor. So NSE can be taken as a reliable clinical way of predicting prognosis after severe brain injury.更多还原