急性前循环脑梗死患者梗死体积与血清NSE水平相关性的研究

发布时间：2019-02-23 23:45

【摘要】：目的观察神经元特异性烯醇化酶（NSE）在急性脑梗死患者发病早期（24h内）的血清含量，并计算出颅脑磁共振的DWI此时对应的脑梗死体积，探讨二者之间的相关性，评价血清神经元特异性烯醇化酶在急性脑梗死患者病情评估、预后判断中的临床价值。方法急性脑梗死患者出现症状24小时之内采集静脉血，采用ELISA法检测血清初始NSE水平。患者发病3天内行颅脑磁共振检查，并根据颅脑磁共振的DWI相计算出此时的脑梗死体积。使用TOAST分类评价，将患者分为大动脉疾病组，心源性脑栓塞组，小血管疾病组,发病机制不能确定组。同时用美国国家卫生研究院卒中量表分别评估患者入院时及出现症状后1周的得分。计算出患者入院时血清初始神经元特异性烯醇化酶水平与颅脑MRI-DWI序列计算的梗塞灶体积（Spearman)的等级相关系数R，观察二者之间是否有相关性。结果 1.病人组血清初始NSE水平显著高于对照组（P0.001），差异有统计学意义。 2.血清初始NSE水平与颅脑磁共振的DWI相计算出的脑梗死体积呈高度相关（R=0.736，P0.001）。 3.血清初始NSE水平与刚入院时NIHSS评分呈高度相关（R=0.725，P0.001），与发病后1周时NIHSS评分呈高度相关（R=0.785，P0.001）。结论 NSE作为神经元损伤的定量生化标志物，其水平高低不仅能反映脑卒中后脑组织及神经功能损伤的严重程度，，而且可作为急性脑梗死患者病情监测和预后评估的一项重要指标。
[Abstract]:Objective to observe the serum content of neuron-specific enolase (NSE) in the early stage (24 h) of acute cerebral infarction (ACI), and to calculate the volume of cerebral infarction corresponding to DWI of brain magnetic resonance (MRI), and to explore the correlation between them. To evaluate the clinical value of serum neuron-specific enolase in evaluating the condition and prognosis of patients with acute cerebral infarction. Methods Venous blood samples were collected from patients with acute cerebral infarction within 24 hours after onset of symptoms. Serum initial NSE levels were measured by ELISA method. The cerebral infarction volume was calculated according to the DWI phase of MRI. The patients were divided into 4 groups by TOAST classification: large artery disease group, cardiogenic cerebral embolism group, small vascular disease group, and the pathogenesis of the disease could not be determined. At the same time, the National Institutes of Health Stroke scale was used to evaluate the patients' scores on admission and 1 week after symptoms. The level of initial neuron-specific enolase at admission was calculated and the correlation coefficient R of infarct volume (Spearman) calculated by brain MRI-DWI sequence was calculated, and the correlation between the two was observed. Result 1. The serum initial NSE level in the patient group was significantly higher than that in the control group (P 0. 001). 2. There was a high correlation between the initial serum NSE level and the cerebral infarct volume calculated by DWI phase of craniocerebral magnetic resonance imaging (RP0.001). 3. The initial serum NSE level was highly correlated with the NIHSS score at admission (RV 0.725 P0.001), and with the NIHSS score at 1 week after onset (RV 0.785U P0.001). Conclusion as a quantitative biochemical marker of neuronal injury, the level of NSE can not only reflect the severity of brain tissue and nerve function injury after stroke. It can also be used as an important index for monitoring and prognosis evaluation of acute cerebral infarction patients.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.33

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