动态监测抗凝血酶Ⅲ与神经元特异性烯醇化酶水平对脑外伤病情和预后评估的意义
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摘要
目的探讨动态监测脑外伤患者血清抗凝血酶Ⅲ(AT-Ⅲ)及神经元特异性烯醇化酶(NSE)水平对病情和预后评估的意义。方法检测60例脑外伤患者(脑外伤组)入院时、伤后第3、7天和20例健康志愿者(对照组)的血清AT-Ⅲ和NSE水平。脑外伤组按GCS评分再分为GCS≤8分组(30例)和GCS>8分组(30例);按患者预后再分为预后良好组(43例)、预后不良组(10例)和死亡组(7例)。结果脑外伤组入院时和伤后第3、7天的AT-Ⅲ和NSE水平均高于对照组(P<0.05或P<0.01)。入院时和伤后第3、7天,GCS≤8分组的AT-Ⅲ和NSE水平均高于GCS>8分组和对照组(P<0.05或P<0.01)。预后不良组和死亡组的AT-Ⅲ、NSE水平均高于预后良好组(P<0.05或P<0.01)。结论早期动态监测血清AT-Ⅲ和NSE水平对评估脑外伤患者病情和预后具有重要的临床意义。
Objective To investigate the value of dynamic detection of antithrombin-Ⅲ(AT-Ⅲ)and neuron-specific enolase(NSE)in evaluating the illness status and prognosis of the patients with traumatic brain injury.Methods Serum levels of AT-Ⅲ and NSE were detected in 60 patients with traumatic brain injury(group A)on admission,in the 3 rd and 7 th day after brain injury and 20 healthy volunteers(group B).The patients in group A were subdivided into groups of A1(GCS≤8 points,30 cases)and A2(GCS>8 points,30 cases)or A3(with favorable prognosis,43 cases),A4(with poor prognosis,10 cases)and A5(death,7 cases).Results Serum levels of AT-Ⅲand NSE were higher in group A than those in group B on admission and on the 3 rd and 7 th day after brain injury(P<0.05 or P<0.01),which were higher in group A1 than those in groups of A2 and B(P<0.05 or P<0.01)and were higher in groups of A4 and A5 than those in group A3(P<0.05 or P<0.01).Conclusion Early dynamic detection of serum AT-Ⅲ and NSE has an important clinical significance in evaluating the illness status and prognosis of the patients with traumatic brain injury.
Objective To investigate the value of dynamic detection of antithrombin-Ⅲ(AT-Ⅲ)and neuron-specific enolase(NSE)in evaluating the illness status and prognosis of the patients with traumatic brain injury.Methods Serum levels of AT-Ⅲ and NSE were detected in 60 patients with traumatic brain injury(group A)on admission,in the 3 rd and 7 th day after brain injury and 20 healthy volunteers(group B).The patients in group A were subdivided into groups of A1(GCS≤8 points,30 cases)and A2(GCS>8 points,30 cases)or A3(with favorable prognosis,43 cases),A4(with poor prognosis,10 cases)and A5(death,7 cases).Results Serum levels of AT-Ⅲand NSE were higher in group A than those in group B on admission and on the 3 rd and 7 th day after brain injury(P<0.05 or P<0.01),which were higher in group A1 than those in groups of A2 and B(P<0.05 or P<0.01)and were higher in groups of A4 and A5 than those in group A3(P<0.05 or P<0.01).Conclusion Early dynamic detection of serum AT-Ⅲ and NSE has an important clinical significance in evaluating the illness status and prognosis of the patients with traumatic brain injury.
引文
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[11]Einav S,Kaufman N,Algur N,et al.Modeling serum biomarkers S100beta and neuron-specific enolase as predictors of outcome after out-of-hospital cardiac arrest:an aid to clinical decision making[J].J Am Coll Cardiol,2012,60(4):304-311.
[2]Carrick MM,Tyroch AH,Youens CA,et al.Subsequent development of thrombocytopenia and coagulopathy in moderate and severe head injury:support for serial laboratory examination[J].J Trauma,2005,58(4):725-729.
[3]王博.不同程度颅脑损伤患者凝血功能及预后特点分析[J].中国实用神经疾病杂志,2016,19(11):115-116.
[4]Vondrakova D,Kruger A,Janotka M,et al.Association of neuron-specific enolase values with outcomes in cardiac arrest survivors is dependent on the time of sample collection[J].Crit Care,2017,21(1):172.
[5]耿建红,刘志辉,李雪梅,等.血清神经元特异性烯醇化酶对癫痫发作和晕厥的鉴别诊断价值[J].临床内科杂志,2012,29(10):670-672.
[6]Berqer RP,Fromkin J,Rubin P,et al.Serum D-dimer concentrations are increased after pediatric traumatic brain injury[J].J Pediatr,2015,166(2):383-388.
[7]叶珊,林绍鹏,解龙昌.血清神经元特异性烯醇化酶水平与缺血性卒中脑损伤程度的相关性[J].天津医药,2014,42(7):674-676.
[8]余万,黄保胜,陆晓诚,等.创伤性脑损伤患者血清泛素羧基末端水解酶L1和神经元特异性烯醇化酶含量测定及临床意义[J].江苏医药,2014,40(7):771-773.
[9]Joseph B,Aziz H,Zangbar B,et al.Acquired coagulopathy of traumatic brain injury defined by routine laboratory tests:which laboratory values matter[J]?J Trauma Acute Care Surg,2014,76(1):121-125.
[10]刘宝南.颅脑损伤的凝血纤溶功能异常与进展性颅内出血的相关性研究[J].检验医学与临床,2015,12(14):2100-2102.
[11]Einav S,Kaufman N,Algur N,et al.Modeling serum biomarkers S100beta and neuron-specific enolase as predictors of outcome after out-of-hospital cardiac arrest:an aid to clinical decision making[J].J Am Coll Cardiol,2012,60(4):304-311.