大面积脑梗死患者颅内压与血清NSE、S-100B蛋白变化的关系
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摘要
目的分析大面积急性脑梗死患者颅内压变化与血清神经元特异性烯醇化酶(neuron-specificenolase,NSE)、S-100B蛋白变化的关系。方法选择符合标准的30例大面积脑梗死患者,应用无创颅内压监测仪监测颅内压,对符合标准患者进行入院后24h内以及发病后第3天、第5天、第7天颅内压的动态监测,应用酶联免疫吸附测定法监测同时期患者血清NSE、S-100B蛋白水平,并与30例健康人(对照组)比较,对大面积脑梗死患者急性期颅内压变化与血清NSE、S-100B蛋白含量变化进行相关性分析。结果发病24h内病例组颅内压、血清NSE和S-100B蛋白水平均高于对照组,差异有统计学意义(P<0.05);病例组入院第3天、第5天、第7天颅内压、血清NSE和S-100B蛋白水平均高于入院24h,在入院第7天开始下降,但仍高于入院24h,差异均有统计学意义(P<0.05)。结论大面积脑梗死患者颅内压变化伴随着血清NSE和S-100B蛋白水平变化,可通过测定血清NSE、S-100B蛋白含量变化间接反映颅内压变化,对临床评估病情严重程度及预后有一定参考价值。
Objective To analyze the relationship between the changes of intracranial pressure in patients with massive acute cerebral infarction and the changes of serum neuron specific enolase neuron-specific enolase(NSE)and S-100 Bprotein.Methods Thirty patients with large area cerebral infarction who met the criteria were selected,and non-invasive intracranial pressure monitor was used to monitor intracranial pressure.Dynamic monitoring of intracranial pressure was performed on patients who met the criteria within 24 hafter admission,3 days after onset,5 days after onset,and 7 days after onset.The application of enzyme linked immunosorbent assay in monitoring the protein level of S-100 Bprotein and serum NSE,and compared with 30 healthy people(control group),the serum level of NSE and S-100 Bprotein subtype and the intracranial pressure were made for the content correlation analysis.Results The intracranial pressure,specific enolase and serum S-100 B protein in the case group were significantly higher than those in the control group within 24 hafter onset.The difference was statistically significant(P<0.05).In the case group,after the onset of 3 d,5 d,7 dof the intracranial pressure,the specific enolase and serum S-100 B protein were higher than the admission of 24 h,and began to decline on the 7 days after admission,but still higher than admission for 24 h.The difference was statistically significant(P<0.05).Conclusion The changes of intracranial pressure in patients with massive cerebral infarction accompanied by changes in serum NSE and S-100 Bprotein levels can reflect the changes of intracranial pressure indirectly by measuring the changes of serum NSE and S-100 Bprotein levels,expecting to become a certain reference value for clinical evaluation of the severity and prognosis of the disease.
Objective To analyze the relationship between the changes of intracranial pressure in patients with massive acute cerebral infarction and the changes of serum neuron specific enolase neuron-specific enolase(NSE)and S-100 Bprotein.Methods Thirty patients with large area cerebral infarction who met the criteria were selected,and non-invasive intracranial pressure monitor was used to monitor intracranial pressure.Dynamic monitoring of intracranial pressure was performed on patients who met the criteria within 24 hafter admission,3 days after onset,5 days after onset,and 7 days after onset.The application of enzyme linked immunosorbent assay in monitoring the protein level of S-100 Bprotein and serum NSE,and compared with 30 healthy people(control group),the serum level of NSE and S-100 Bprotein subtype and the intracranial pressure were made for the content correlation analysis.Results The intracranial pressure,specific enolase and serum S-100 B protein in the case group were significantly higher than those in the control group within 24 hafter onset.The difference was statistically significant(P<0.05).In the case group,after the onset of 3 d,5 d,7 dof the intracranial pressure,the specific enolase and serum S-100 B protein were higher than the admission of 24 h,and began to decline on the 7 days after admission,but still higher than admission for 24 h.The difference was statistically significant(P<0.05).Conclusion The changes of intracranial pressure in patients with massive cerebral infarction accompanied by changes in serum NSE and S-100 Bprotein levels can reflect the changes of intracranial pressure indirectly by measuring the changes of serum NSE and S-100 Bprotein levels,expecting to become a certain reference value for clinical evaluation of the severity and prognosis of the disease.
引文
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[20]李季林,盛罗平,陈仁辉,等.颅脑损伤后血清中MMP-9、S-100B蛋白的表达与颅脑损伤严重程度及脑水肿相关性的研究[J].创伤外科杂志,2017,19(3):185-188.
[21]朱青川.急性脑梗死患者血清NSE及S-100B蛋白动态变化及意义[J].中外医学研究,2017,15(10):54-55.
[22]刘联平.血清S-100B蛋白、NSE及GST水平与急性脑梗死患者病情、预后的相关性研究[J].西南军医,2016,18(2):137-139.
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[2]董雯,李保玉,屈园利,等.急性脑血管病发病特点的研究[J].中国中医急症,2016,25(2):254-255,267.
[3]周映彤,刘李攀,黎罗明,等.52例大面积脑梗死患者颅内压动态监测的临床分析[J].吉林医学,2017,38(1):16-17.
[4]方黎晓,胡少玄,徐洪飞,等.有创颅内压监测在重型颅脑损伤患者术后治疗中的价值[J].检验医学与临床,2016,13(12):1631-1632,1635.
[5]Syed H,Unnikrishnan VU,Olcmen S.Characteristics of timevarying intracranial pressure on blood flow through cerebral artery:a fluid-structure interaction approach[J].Proc Inst Mech Eng H,2016,230(2):111-121.
[6]景增秀.缺血性脑卒中患者血清中S100B、半乳糖凝集素-3和神经元特异性烯醇化酶的表达及意义[J].中国老年学杂志,2016,36(3):623-625.
[7]陈锦景,张旸,朱春然,等.血清S100B和NSE联合检测对颅脑损伤患者预后判断的价值[J].现代医学,2016,44(11):1602-1604.
[8]于海东,高麟,李海龙,等.持续颅内压监测在重型颅脑损伤患者治疗中的应用[J].中国临床研究,2015,28(2):212-213,216.
[9]王立江,元小冬.有创颅内压监测技术在重型颅脑损伤患者中的应用价值[J].解放军医药杂志,2017,29(8):55-59.
[10]王忠,苏宁,吴日乐,等.显微血肿清除术及标准大骨瓣减压术治疗重症大面积脑出血及早期颅骨修补的临床研究[J].河北医科大学学报,2016,37(8):903-907.
[11]潘运高.高渗盐水治疗大面积脑梗死继发脑水肿、颅高压的价值研究[J].中国实用医药,2015,10(16):169-170.
[12]任军伟,吴惺.自发性脑出血患者的颅内压、脑灌注压与血压调控研究进展[J].国际神经病学神经外科学杂志,2016,43(3):251-254.
[13]郭清保,谢曼丽,杨彦龙,等.大骨瓣减压联合亚低温对大面积脑梗死病人血清hs-CRP、NSE、S100-β3蛋白水平的影响[J].中西医结合心脑血管病杂志,2017,15(18):2360-2363.
[14]滕悦,袁成,朱爱玲.血清ProGRP和NSE在小细胞肺癌化疗疗效评价中的应用价值[J].临床和实验医学杂志,2017,16(24):2440-2442.
[15]郭映辉,李梅,刘新光,等.动态监测血清caspase-3和NSE在新生儿缺氧缺血性脑病诊治中的价值[J].河北医科大学学报,2016,37(9):1069-1072.
[16]张建国,张德厚,胡振奎,等.NSE、D-D、CRP在重型颅脑损伤病情判断中的价值[J].脑与神经疾病杂志,2017,25(12):749-752.
[17]李岚.非小细胞肺癌患者化疗前后血清多种指标水平的变化及临床意义[J].临床肺科杂志,2018(1):178-181.
[18]Damude S,Wevers KP,Murali R,et al.A prediction tool incorporating the biomarker S-100Bfor patient selection for completion lymph node dissection in stageⅢmelanoma[J].Eur J Surg Oncol,2017,43(9):1753-1759.
[19]Egashira Y,Zhao H,Hua Y,et al.White matter injury after subarachnoid hemorrhage:role of blood-brain barrier disruption and matrix metalloproteinase-9[J].Stroke,2015,46(10):2909-2915.
[20]李季林,盛罗平,陈仁辉,等.颅脑损伤后血清中MMP-9、S-100B蛋白的表达与颅脑损伤严重程度及脑水肿相关性的研究[J].创伤外科杂志,2017,19(3):185-188.
[21]朱青川.急性脑梗死患者血清NSE及S-100B蛋白动态变化及意义[J].中外医学研究,2017,15(10):54-55.
[22]刘联平.血清S-100B蛋白、NSE及GST水平与急性脑梗死患者病情、预后的相关性研究[J].西南军医,2016,18(2):137-139.
[23]Gultekin R,Huang S,Clavisi O,et al.Pharmacological interventions in traumatic brain injury:can we rely on systematic reviews for evidence[J].Injury,2016,47(3):516-524.