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目的:观察缺血性脑卒中(CIS)患者发病早期神经元特异性烯醇化酶(NSE)和同型半胱氨酸(Hcy)含量,及其与神经功能缺损评分的相关性。方法 :收集我院附属医院内科2011年1月至2015年11月收治的CIS初发患者278例(CIS组),按照梗死面积大小,分大面积组(55例)、中面积组(49例)、小面积组(39例)及腔隙性组(135例),最终确定为进展性脑卒中98例,并选择健康体检人群260例做为对照组。利用酶联免疫与荧光偏振免疫分析法分别检测各CIS组与对照组NSE和Hcy含量,并检测进展性脑卒中(SIP)发病2d、3d时的NSE和Hcy含量,同时分析两者与对应神经功能缺损评分(NIHSS)的相关性。结果:各组脑卒中患者的NSE含量均较对照组显著升高(P<0.01);Hcy含量也明显高于对照组(P<0.01或<0.05);各CIS组间分别比较NSE、Hcy含量及NIHSS评分,差异均有统计学意义(P<0.05);各CIS组NIHSS评分与相应NSE、Hcy含量呈正相关;SIP患者,第2、3天NSE分别为(28.5±9.7)μg/L、(33.6±11.7)μg/L,差异有统计学意义(P<0.05),第2、3天NIHSS评分差异有显著性意义(P<0.01),而第2、3天的Hcy含量比较无统计学意义(P>0.05)。结论 :在缺血性脑卒中患者发病早期,血清NSE与Hcy含量可用于判断患者脑梗死面积与神经元损伤程度,且NSE在反映微小损伤时比Hcy更加敏感。
OBJECTIVE: To observe the levels of neuron-specific enolase (NSE) and homocysteine (Hcy) in the early stage of onset of ischemic stroke (CIS) and its relationship with neurological deficit score. Methods: A total of 278 primary CIS patients (CIS group) admitted to our hospital from January 2011 to November 2015 were enrolled in this study. According to infarct size, 55 cases were divided into large area group (49 cases ), Small-area group (39 cases) and lacunar group (135 cases), and finally identified as 98 cases of progressive stroke, and 260 healthy people were selected as the control group. The levels of NSE and Hcy in each CIS group and control group were detected by enzyme-linked immunosorbent assay (ELISA) and fluorescence polarization immunoassay, respectively. The levels of NSE and Hcy in progressive ischemic stroke (SIP) were detected at 2 days and 3 days respectively. Correlation of NIHSS. Results: The levels of NSE in stroke group were significantly higher than those in control group (P <0.01), and the levels of Hcy in cerebral stroke group were significantly higher than those in control group (P <0.01 or <0.05). The levels of NSE and Hcy (P <0.05). There was a positive correlation between NIHSS scores and corresponding NSE and Hcy levels in each CIS group. The NSE in the second and third days of SIP patients were (28.5 ± 9.7) μg / L, (33.6 ± 11.7) μg / L, the difference was statistically significant (P <0.05), the NIHSS scores on the 2nd and 3rd days were significantly different (P <0.01), while on the 2nd and 3rd days, there was no statistical difference Significance (P> 0.05). Conclusion: In the early stage of onset of ischemic stroke, the levels of serum NSE and Hcy can be used to judge the area of cerebral infarction and neuron injury in patients with NSE, and NSE is more sensitive than Hcy in reflecting minor injuries.