贵州医科大学学报

2018, v.43;No.215(08) 938-942

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血清同型半胱氨酸与神经元特异性烯醇化酶联合检测对进展性脑梗死的预测价值
The Prediction Value of Combined Serum Homocysteine and Neuron Specific Enolase in Progressive Cerebral Infarction

代鸣明;于航;苏庆杰;龙发青;吴映曼;王德生;张余辉;陈斌;王布飞;肖英;高畅;
DAI Mingming;YU Hang;SU Qingjie;LONG Faqing;WU Yingman;WANG Desheng;ZHANG Yuhui;CHEN Bin;WANG Bufei;XIAO Ying;GAO Chang;Department of Neurology,the Second Affiliated Hospital of Hainan Medical College Hainan;Department of Critical Care Medicine,the Second Affiliated Hospital of Hainan Medical College;Department of Pathophysiology,Hainan Medical College;

摘要(Abstract):

目的:探讨血清同型半胱氨酸(HCY)联合神经元特异性烯醇化酶(NSE)检测对进展性脑梗死(PCI)的预测价值。方法:200例急性脑梗死患者,根据发病24 h内头颅磁共振(MRI-DWI)结果分为大梗死灶组(n=39)、中梗死灶组(n=83)及小梗死灶组(n=78),根据病情进展情况分为进展组(n=78)及非进展组(n=122),分别于发病第1、2、3、7及14天时检测患者血清HCY、NSE水平,发病第1及7天时采用NIHSS评分、改良Barthel指数(MBI)评分评估患者神经功能缺血症状;比较3组不同大小脑梗死灶患者第1天的血清HCY、NSE水平,比较进展组及非进展组患者发病第1、2、3、7及14天时的血清HCY、NSE水平,采用Pesrson相关法分析进展性脑梗死患者NIHSS评分、MBI评分与NSE、HCY水平的相关性。结果:脑梗死各组第1天时的血清HCY、NSE水平随病灶的增大而升高(P<0.05),进展组患者第1、2、3及7天时血清HCY、NSE水平高于非进展组(P<0.05),第14天时2组患者HCY、NSE水平比较,差异无统计学意义(P>0.05);进展组患者在发病后第1、2及3天时血清HCY、NSE水平逐渐升高,第7天后逐渐降低;Pearson相关分析结果显示,进展性脑梗死患者发病第1及7天时的血清HCY、NSE水平与患者NHISS、MBI评分呈正相关(P<0.01)。结论:血清HCY、NSE联合检测能可反映脑梗死神经功能损害程度,可作为进展性脑梗死的有效预测指标。
Objective: To investigate the prediction value of combined homocysteine( HCY) and neuron specific enolase( NSE) in progressive cerebral infarction. Methods: 200 patients with acute cerebral infarction were selected. According to the results of MRI-DWI sequence in the head within 24 hours of illness,the patients were divided into large( n = 39),medium( n = 83) and small( n = 78)infarction groups. The patients were further divided into progression group( n = 78) and non-progression group( n = 122); NSE and HCY levels were tested on the 1~(st),2~(nd),3~(rd),7~(th) and 14~(th) day; NIHSS score and modified Barthel index( MBI) score were adopted to assess the neurological deficit score of patients on the 1 stand 7 th day after onset of illness. Comparing serum HCY and NSE level on the 1 st day after admission of three groups; comparing serum HCY and NSE level of both progression and nonprogression groups on the 1~(st),2~(nd),3~(rd),7~(th) and 14~(th) day; Pearson correlation analysis was used to analyze the correlation between NIHSS score,MBI score and NSE,HCY levels in patients with progressive cerebral infarction. Results: on the 1 stday,the levels of serum HCY and NSE increased with the development of the lesion( P < 0. 05); on the 1~(st),2~(nd),3~(rd) and 7~(th) day,serum NSE and HCY of progression group were significantly higher than those of non-progression group. There was no significant difference on the 14~(th) day of the HCY and NSE comparison between both groups( P > 0. 05). 1~(st),2~(nd) and 3~(rd) day after the onset of illness,serum HCY and NSE level increased gradually in progression group and decreased gradually on the 7~(th) day. According to Pearson analysis,the levels of serum NSE and HCY in patients with progressive cerebral infarction were positively correlated with NIHSS score and MBI score P < 0. 01). Conclusion: Serum HCY and NSE combined detection can reflect the degree of neurological damage in cerebral infarction,which may be an effective predictor of progressive cerebral infarction.

关键词(KeyWords): 脑梗塞,进展性;同型半胱氨酸;神经元特异性烯醇化酶;美国国立卫生研究院卒中量表;改良Barthel指数
cerebral infarction,progressive;homocysteine;neuron specific enolase;National Institutes of Health Stroke Scale;Modified Barthel Index

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81660270);; 海南省卫计委行业科研项目(1601032054A2001);; 海南医学院科研培育基金(HY2016-07)

作者(Author): 代鸣明;于航;苏庆杰;龙发青;吴映曼;王德生;张余辉;陈斌;王布飞;肖英;高畅;
DAI Mingming;YU Hang;SU Qingjie;LONG Faqing;WU Yingman;WANG Desheng;ZHANG Yuhui;CHEN Bin;WANG Bufei;XIAO Ying;GAO Chang;Department of Neurology,the Second Affiliated Hospital of Hainan Medical College Hainan;Department of Critical Care Medicine,the Second Affiliated Hospital of Hainan Medical College;Department of Pathophysiology,Hainan Medical College;

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DOI: 10.19367/j.cnki.1000-2707.2018.08.015

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