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目的 探讨急性脑梗死患者血浆神经元特异性烯醇酶 (neuronspecificenolase ,NSE)的动态变化及其与预后的关系。方法 选择急性脑梗死患者 6 8例 ,分别于发病后 3d以内 (6 8例 )、第 7天 (6 6例 )、第14天 (6 5例 )、第 30天 (6 4例 )采集血标本 ,应用酶联免疫吸附法测定血浆NSE水平 ,检测结果与 35例正常对照组比较 ,探讨脑梗死患者血浆NSE水平与脑梗死体积及临床神经功能改善的相关性。结果 脑梗死患者发病 3天内、第 7天血浆NSE水平明显高于对照组 ,以 3天内变化最显著 (t值分别为 11 2 9,6 5 4 ;P <0 0 0 1) ;预后不良组血浆NSE水平在 3d内 (12例 )、第 7天 (10例 )、第 14天 (9例 )各时间点均明显高于预后良好组 (5 6例 ) (t值分别为 5 99,3 5 8,2 2 6 ;P <0 0 5 )。 6 6例脑梗死患者第 7天的脑梗死体积与其发病 3d以内、第 7天血浆NSE水平呈正相关 ,相关系数分别为 0 83、 0 75 (P<0 0 0 1)。 6 4例脑梗死患者第 30天神经功能缺损评分减少值与 3天以内、第 7天血浆NSE水平呈负相关 ,相关系数分别为 - 0 4 1(P <0 0 1)、 - 0 37(P <0 0 1)。结论 急性脑梗死患者早期血浆NSE水平明显升高 ,血浆NSE的动态变化可以反映脑梗死的严重程度及其近期预后
Objective To investigate the dynamic changes of plasma neuron specific enolase (NSE) in patients with acute cerebral infarction and its relationship with prognosis. Methods Sixty-eight patients with acute cerebral infarction were selected, and the blood samples were collected within 3 days (68 cases), 7 days (6 6 cases), 14 days (65 cases) and 30 days (64 cases) The serum levels of NSE were measured by enzyme-linked immunosorbent assay (ELISA). The results were compared with those of 35 normal control subjects. The correlation between plasma NSE levels and infarction volume and clinical neurological function was evaluated. Results The levels of plasma NSE in the patients with cerebral infarction within 3 days after onset were significantly higher than those in the control group on day 7, with the most significant changes in 3 days (t = 11 2 9, 65 4, P 0 01), poor prognosis The levels of plasma NSE were significantly higher in the third (12 cases), the seventh (ten) and the fourteenth (nine) days than in the good prognosis group (t = 5 99.3 5 8,2 2 6; P <0 0 5). Sixty-six cerebral infarction patients had a positive correlation between the volume of cerebral infarction on day 7 and the level of plasma NSE on the 7th day, with correlation coefficients of 0 83 and 0 75 (P 0 01), respectively. The decrease of neurological deficit score on the 30th day in the 64 patients with cerebral infarction was negatively correlated with plasma NSE level on the 7th day and the correlation coefficients were -0.41 (P <0.01), -0.37 P <0 0 1). Conclusion The plasma levels of NSE in patients with acute cerebral infarction are significantly increased. The dynamic changes of plasma NSE can reflect the severity of cerebral infarction and its recent prognosis