【摘要】 背景:S-100b,神经元特异性烯醇化酶(neuron-specificenolase,NSE)可以作为神经元损伤的生化标志物,但其预测缺血性神经元损伤的程度及神经功能缺损程度尚不太清楚。目的:探讨S-l00b蛋白、NSE预测神经元损伤程度及神经功能缺损程度以及血糖升高与神经元损伤之间的关系。设计:以诊断为依据的非随机对照研究。地点和对象:2002-03/2003-03洪泽县人民医院神经科住院脑梗死患者43例,男23例,女20例,年龄52～83岁,排除脑部其他疾病。对照组为同期本院门诊健康体检者33例,男19例,女14例,年龄48～80岁。方法:应用ELISA法测定S-100b,NSE血清水平,脑CT测量脑梗死体积(多田氏公式计算梗死体积)。神经功能缺损程度用美国国立健康研究所制定的急性脑卒中评定量表(NIHSS)评分。主要观察指标:①两组患者血清S-l00b,NSE水平。②血清S-l00b,NSE水平与梗死体积及神经功能缺损程度的关系。结果:脑梗死组在病程各时点上血清S-l00b,NSE水平与对照组相比均升高,于病后24h内即开始升高,分别为(1.64±0.41)μg/L,(8.54±2.37)μg/L;第3天达高峰犤(2.15±0.42)μg/L,(11.36±3.14)μg/L犦;第7天仍未恢复至正常水平犤(1.74±0.38)μg/L,(9.13±2.58)μg/L犦。第3天S-l00b与梗死体积及临床症状严重程度呈正相关(r=0.64,0.49,P<0.001,0更多还原

【Abstract】 BACKGROUND:S 1oob and neuron specific enolase(NSE) can be used as chemical markers of neuron damage.However,it is not clear to which extent S 100b and NSE can predict ischemic neuron damage and neurologic impairment. OBJECTIVE:To investigate to which extent S 100b and NSE can predict ischemic neuron damage and neurologic impairment, and the relationship between hyperglycemia and neuron damage. DESIGN:Diagnosis based non randomized control study. SETTING and PARTICIPANTS:The study was conducted in the People’s Hospital of Hongze County during the March 2002 and March 2003.Forty three patients with cerebral infarction aged 52-83 years(23 males and 20 females) and 33 health control subjects aged 48-80 years(19 males and 14 females) entered the study. INTERVENTIONS:Serum level of S 100b and NSE was measured by Enzyme Linked Immunosorbent Assay.The cerebral infarction area was measured by using CT.NIHSS was used to assess the neurologic impairment. MAIN OUTCOME MEASURES:①Serum level of S 100b and NSE in both groups.②Correlations between the level of S 100b and NSE and the area of cerebral infarction. RESULTS:At all time points of examination, serum level of S 100b and NSE was always higher in the infarction group than that in the control group. The level of S 100b and NSE was elevated from 24 hours post infarction onwards, at a level(1.64±0.41) μg/L and(8.54±2.37) μg/L.The peak value[(2.15±0.42) μg/L,(11.36±3.14) μg/L] was achieved at the third day post infarction .The levels of S 1oob and NSE did not return to normal until 7 days post infarction[(1.74±0.38),(9.13±2.58) μg/L]. It showed a positive association between the level of S 100b and the area of cerebral infarction and between the level of S 100b and the severity of clinical presentations at day 3(r=0.64,0.49,P< 0.001,P< 0.002).There was a positive correlation between the level of NSE and the area of cerebral infarction.(r=0.39,P< 0.05) while there was no significant correlation between NSE level and the severity of clinical presentations(r=0.15,P >0.05).The level of S 100b and NSE was significantly higher in the cerebral infarction with hyperglycemia than that in the group of patients with cerebral infarction with normal glycemia. CONCLUSION:Serum level of S 100b and NSE are sensitve chemical markers for predicting the extent of ischemic neuron damage and loss of neural function.Hyperglycemia can result in a more severe ischemic cerebral injury.更多还原