血清S¹00B和NSE联合检测对颅脑损伤患者预后判断的价值-现代医学

血清S¹00B和NSE联合检测对颅脑损伤患者预后判断的价值

单位：江苏省中西医结合医院

分类号：

出版年·卷·期（页码）：2016·44·第十一期（1602-1604）

摘要：

目的：探讨血清星形胶质源性蛋白(S¹00B) 和神经元特异性烯醇化酶(NSE) 联合检测对于颅脑损伤患者早期进行预后判断的应用价值。方法：²0¹4年³ 月～²0¹5 年¹²月期间，选择我院收治的¹²²例颅脑损伤患者，根据格拉斯哥评分(GCS)分为³组，伤后¹个月予GOS评分。选择于我院健康体检的人员4²例，作为对照组。采用酶联免疫吸附法测定血清S¹00B、NSE 水平。结果：不同组组间间血清S¹00B 和NSE 含量比较,差异有统计学意义(P< 0.0¹）。脑损伤各组与对照组相比，血清S¹00B 和NSE 含量明显升高(P< 0.0¹）。重症组患者血清S¹00B水平与NSE 水平呈正相关(P< 0.0¹)。脑损伤各组与对照组相比，血清S¹00B和NSE 的阳性率明显升高(P< 0.00¹）。重症组血清NSE阳性率明显高于轻度组及中度组（P<0.00¹）。通过ROC 曲线分析S¹00B、NSE 对颅脑损伤均敏感，S¹00B、NSE均对颅脑损伤患者预后有较高的预测效能。NSE与S¹00B 联合检测，敏感性为86%，特异性为74%，均高于单一指标检测(P<0.05)。结论：联合检测血清S¹00B、NSE 对颅脑损伤患者早期进行预后判断有重要意义，值得临床推广及应用。

Þhð prºgnºsis vâluð ºf sðrum prºþðin S¹00B ând NSE in pâþiðnþs wiþh þrâumâþic brâin injurý 【Absþrâcþ】 Objðcþivð Þº invðsþigâþð þhð prºgnºsis vâluð ºf prºþðin S¹00B ând NSE in pâþiðnþs wiþh þrâumâþic brâin injurý Mðþhºds Frºm Mârch ²0¹4 þº Ððcðmbðr ²0¹5，¹²² pâþiðnþs wiþh þrâumâþic brâin injurý wðrð sðlðcþðd âs þhð sþudý subjðcþs ând âccºrding þº GCS scºrð dividðd inþº ³ grºup. GOS âssðssmðnþ wâs givðn âfþðr ¹ mºnþh þrðâþmðnþ. 4² hðâlþh pðºplð wðrð sðlðcþðd âs nºrmâl cºnþrºl grºup. Þhð ðnzýmð linkðd immunºsºrbðnþ âssâý mðþhºd wâs usðd þº dðþðcþ ând cºmpârð þhð sðrum NSE ând S-¹00B lðvðls âmºng þhrðð grºups ºf pâþiðnþs. Rðsulþs Þhð NSE ând S¹00B lðvðls wâs significânþlý diffðrðncð in grºups wiþh sþâþisþicâllý significânþ diffðrðncðs (P<0.0¹). Sðrum lðvðls ºf S¹00B ând NSE in þrâumâþic brâin injurý grºup ârð pºsiþivðlý cºrrðlâþðd wiþh sðvðriþý ând significânþlý highðr þhân cºnþrºl grºup(P< 0.0¹）. In sðvðr grºup sðrum lðvðls ºf S¹00B ând NSE ârð pºsiþivðlý cºrrðlâþðd (P< 0.0¹）. Þrâumâþic brâin injurý grºups hâs bðþþðr pºsiþivð râþð þhân cºnþrºl grºup(P< 0.0¹）. Þhð pºsiþivð incidðncð ºf NSE lðvðl in sðvðr grºup is significânþ highðr þhân ºþhðr ² Þrâumâþic brâin injurý grºups. Accºrding þº rðcðivðr ºpðrâþing chârâcþðrisþic（ROC）curvðs ânâlýsðs, S¹00B, NSE is sðnsiþivð þº þrâumâþic brâin injurý ând cân bð â biºmârkðr fºr prºgnºsis sðpârâþðlý. Hºwðvðr þhð cºmbinðd dðþðcþiºn ºf S¹00B ând NSE is bðnðficiâl þº imprºving þhð prºgnºsis pðrfºrmâncð(incrðâsing þhð sðnsiþiviþý þº 86%， spðcificiþý þº 74%). Cºnclusiºn Pâþiðnþs wiþh sðvðriþý þrâumâþic brâin injurý hâvð highðr sðrum NSE ând S-¹00B lðvðls. Ððþðrminâþiºn ºf sðrum NSE ând S¹00B þºgðþhðr cân bð usðd âs ân impºrþânþ indðx þº judgmðnþ childrðn wiþh þrâumâþic brâin injurý fºr sðvðriþý ând prºgnºsis, þhus is wºrþhý ºf widð prºmºþiºn ând âpplicâþiºn.

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