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目的 :探讨血清神经元特异性烯醇化酶 ( NSE)对自发性幕上出血患者出血量和预后的评估价值。 方法 :采用 EL ISA法检测 5 4例自发性幕上出血患者发病第 1、2、3、4、7、14天的血清 NSE水平。计算脑实质内血肿体积 ,评定脑室出血积分以及发病第 30天时的 Glasgow预后 ( GOS)。 结果 :血清 NSE峰值与血肿体积呈正相关 ( r=0 .5 6 ,P<0 .0 1) ,与 GOS呈显著负相关 ( r=- 0 .5 9,P<0 .0 1) ,与脑室出血积分无相关性 ( r=0 .0 6 ,P=0 .6 7)。不同血肿体积组 NSE在发病第 3天差异显著 ( P<0 .0 1)。 NSE动态曲线在发病 2 4～ 48h时骤升预示死亡。病程中NSE>2 5μg/ L的患者全部死亡。 结论 :血清 NSE变化可以准确反映脑出血量及患者早期预后
Objective: To evaluate the value of serum neuron specific enolase (NSE) in the assessment of bleeding and prognosis in patients with spontaneous supratentorial hemorrhage. Methods: ELSA method was used to detect serum NSE levels on the 1st, 2nd, 3rd, 4th, 7th and 14th days in 54 cases of spontaneous supratentorial bleeding. Calculate intraparenchymal hematoma volume, assess intraventricular hemorrhage score, and Glasgow’s prognosis (GOS) at day 30 of onset. Results: The peak value of serum NSE was positively correlated with the hematoma volume (r = 0.56, P <0.01), and negatively correlated with GOS (r = - 0.59, P <0.01) Ventricular hemorrhage points no correlation (r = 0. 06, P = 0.67). NSE in different hematoma volume groups differed significantly on the 3rd day of onset (P <0.01). NSE dynamic curve in the incidence of 2 4 ~ 48h when the sudden increase indicates the death. Patients with NSE> 25 μg / L during the course of the disease all died. Conclusion: The change of serum NSE can accurately reflect the amount of cerebral hemorrhage and early prognosis of patients