發(fā)布時間：2019-02-23 23:45

【摘要】：目的 觀察神經(jīng)元特異性烯醇化酶（NSE）在急性腦梗死患者發(fā)病早期（24h內(nèi)）的血清含量，并計算出顱腦磁共振的DWI此時對應(yīng)的腦梗死體積，探討二者之間的相關(guān)性，評價血清神經(jīng)元特異性烯醇化酶在急性腦梗死患者病情評估、預(yù)后判斷中的臨床價值。 方法 急性腦梗死患者出現(xiàn)癥狀24小時之內(nèi)采集靜脈血，采用ELISA法檢測血清初始NSE水平�；颊甙l(fā)病3天內(nèi)行顱腦磁共振檢查，并根據(jù)顱腦磁共振的DWI相計算出此時的腦梗死體積。使用TOAST分類評價，將患者分為大動脈疾病組，心源性腦栓塞組，小血管疾病組,發(fā)病機(jī)制不能確定組。同時用美國國家衛(wèi)生研究院卒中量表分別評估患者入院時及出現(xiàn)癥狀后1周的得分。計算出患者入院時血清初始神經(jīng)元特異性烯醇化酶水平與顱腦MRI-DWI序列計算的梗塞灶體積（Spearman)的等級相關(guān)系數(shù)R，觀察二者之間是否有相關(guān)性。 結(jié)果 1.病人組血清初始NSE水平顯著高于對照組（P0.001），差異有統(tǒng)計學(xué)意義。 2.血清初始NSE水平與顱腦磁共振的DWI相計算出的腦梗死體積呈高度相關(guān)（R=0.736，P0.001）。 3.血清初始NSE水平與剛?cè)朐簳rNIHSS評分呈高度相關(guān)（R=0.725，P0.001），與發(fā)病后1周時NIHSS評分呈高度相關(guān)（R=0.785，P0.001）。 結(jié)論 NSE作為神經(jīng)元損傷的定量生化標(biāo)志物，其水平高低不僅能反映腦卒中后腦組織及神經(jīng)功能損傷的嚴(yán)重程度，，而且可作為急性腦梗死患者病情監(jiān)測和預(yù)后評估的一項重要指標(biāo)。
[Abstract]:Objective to observe the serum content of neuron-specific enolase (NSE) in the early stage (24 h) of acute cerebral infarction (ACI), and to calculate the volume of cerebral infarction corresponding to DWI of brain magnetic resonance (MRI), and to explore the correlation between them. To evaluate the clinical value of serum neuron-specific enolase in evaluating the condition and prognosis of patients with acute cerebral infarction. Methods Venous blood samples were collected from patients with acute cerebral infarction within 24 hours after onset of symptoms. Serum initial NSE levels were measured by ELISA method. The cerebral infarction volume was calculated according to the DWI phase of MRI. The patients were divided into 4 groups by TOAST classification: large artery disease group, cardiogenic cerebral embolism group, small vascular disease group, and the pathogenesis of the disease could not be determined. At the same time, the National Institutes of Health Stroke scale was used to evaluate the patients' scores on admission and 1 week after symptoms. The level of initial neuron-specific enolase at admission was calculated and the correlation coefficient R of infarct volume (Spearman) calculated by brain MRI-DWI sequence was calculated, and the correlation between the two was observed. Result 1. The serum initial NSE level in the patient group was significantly higher than that in the control group (P 0. 001). 2. There was a high correlation between the initial serum NSE level and the cerebral infarct volume calculated by DWI phase of craniocerebral magnetic resonance imaging (RP0.001). 3. The initial serum NSE level was highly correlated with the NIHSS score at admission (RV 0.725 P0.001), and with the NIHSS score at 1 week after onset (RV 0.785U P0.001). Conclusion as a quantitative biochemical marker of neuronal injury, the level of NSE can not only reflect the severity of brain tissue and nerve function injury after stroke. It can also be used as an important index for monitoring and prognosis evaluation of acute cerebral infarction patients.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R743.33

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