以颅脑伤为主的多发伤患者血清NSE和MBP的检测及意义

2012-10-17李永领朱烈烈陈大庆

浙江医学教育 2012年3期

关键词：意义血清

李永领，朱烈烈，张荣，陈大庆

(温州医学院附属第二医院，浙江温州 325027)

·基础与临床研究·

以颅脑伤为主的多发伤患者血清NSE和MBP的检测及意义

李永领，朱烈烈，张荣，陈大庆

(温州医学院附属第二医院，浙江温州 325027)

目的：探讨颅脑伤为主多发伤患者血清神经元特异性烯醇化酶(NSE )和碱性髓鞘蛋白(MBP)的变化及其临床意义。方法以正常体检组为对照，用酶联免疫吸附法(ELISA)测定40例颅脑伤为主多发伤患者的血清NSE和MBP含量。结果与对照组相比，颅脑伤为主多发伤患者伤后24小时NSE和MBP水平明显升高，分别为22.85±5.74 ng/ml和12.30±3.29ng/ml(P<0.01)，在不同GCS评分各组患者之间NSE和MBP均不同(P<0.01)；不同ISS评分患者NSE和MBP水平无差异(P>0.05)。结论NSE和MBP可以作为判断以颅脑伤为主多发伤患者脑挫伤病情严重程度和评估预后的指标。

脑损伤；神经元特异性烯醇化酶；碱性髓鞘蛋白；预后

Abstract: [Objective] To investigate the relationship between the serum concentration of neuron-specific enolase (NSE) and myelin basic protein (MBP) in multiple trauma patients with brain contusion and laceration; and its clinical significance. [Method] Serum levels of NSE and MBP were measured in 40 multiple trauma patients with brain contusion and laceration by ELISA method. [Result] The serum level of NSE and MBP were significantly higher in multiple trauma patients with brain contusion and laceration than in normal group within 24 hours (P< 0.01). The serum concentration of NSE and MBP in patients were 22.85±5.74ng/ ml and 12.30±3.29ng/ ml, respectively. The serum level of NSE and MBP had significant difference in patients with different GCS (P<0.01). There were not significant differences about serum NSE and MBP levels of different ISS group patients(p>0.05). [Conclussion] Early elevated NSE and MBP levels in serum may reflect the severity of brain damage of multiple trauma patients with brain injury. They may be important indicators for predicting the prognosis of multiple trauma patients with brain contusion and laceration.

Keywords: brain contusion and laceration ; neuron-specific enolase; myelin basic protein; prognosis

创伤多见于机械性撞击、交通事故、暴力侵害，在工业和交通运输业较为发达的地区，其发病率甚高。颅脑创伤在创伤外科病例中比较常见，常造成脑外伤后遗症，甚至夺去人的生命，对患者家庭及社会造成沉重负担。近年来许多研究已经证实体液中神经元特异性烯醇化酶(Neuron-Specific Enolase，NSE)可以作为脑损伤的标志物[1]。碱性髓鞘蛋白(Myelin Basic Protein，MBP) 属亚临床神经毒性标志[2]，是反映中枢神经系统有无实质性损害较好指标之一。本文以NSE和MBP作为观测指标，探讨颅脑伤为主多发伤患者血清NSE和MBP含量的变化，现报告如下。