急性脑梗死患者血清神经元特异性烯醇化酶和同型半胱氨酸水平变化及其临床意义
| 作者: |
1张燕,
1谢曙文,
1韩能
1 合肥市第二人民医院检验科，合肥 230011 |
| 通讯: |
张燕
Email: nuomiyh1@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.02.010 |
摘要
目的：探讨急性脑梗死患者血清神经元特异性烯醇化酶(neuron-specific enolase，NSE)、同型半胱氨酸(homocysteine，Hcy)水平对病情变化及临床预后的意义，为患者诊疗提供依据。方法：选择2017年1月至2019年12月收治的急性脑梗死120例作为观察组。同期选择100例健康体检人群作为对照组。观察两组血清NSE、D-二聚体(D-dimer，DD)、C反应蛋白(C-reactive protein，CRP)、Hcy水平，比较不同病灶面积及神经功能缺损程度患者血清NSE、Hcy、DD、CRP水平差异，分析上述4项指标与病灶面积、神经功能缺损程度的相关性。结果：观察组患者的血清Hcy、NSE、DD、CRP水平为明显高于对照组，差异有统计学意义(P<0.05)；小梗死灶组患者的血清Hcy、NSE、DD、CRP水平均明显低于中梗死灶组、大梗死灶组，差异有统计学意义(P<0.05)；中梗死灶组患者的血清Hcy、NSE、DD、CRP水平明显低于大梗死灶组，差异有统计学意义(P<0.05)；轻度组患者的血清Hcy、NSE、DD、CRP水平均明显低于中度组、重度组，中度组患者的血清Hcy、NSE、DD、CRP水平均明显低于重度组，差异有统计学意义(P<0.05)；血清Hcy、NSE、DD、CRP水平与梗死面积呈正相关(r1=0.371，r2=0.408，r3=0.329，r4=0.510，P<0.05)；血清Hcy、NSE、DD、CRP水平与患者神经功能缺损程度呈正相关(r1=0.551，r2=0.427，r3=0.291，r4=0.316，P<0.05)。结论：血清Hcy、NSE、DD、CRP水平与急性脑梗死患者的梗死面积、神经功能缺损密切相关，四者可作为评估急性脑梗死病情进展及预后的有效指标。
关键词：
急性脑梗死；神经元特异性烯醇化酶；同型半胱氨酸；D-二聚体；C反应蛋白
Changes of serum neuron-specific enolase and homocysteine in patients with acute cerebral infarction and its clinical significance
CorrespondingAuthor: ZHANG Yan Email: nuomiyh1@126.com
DOI: 10.3978/j.issn.2095-6959.2021.02.010
Abstract
Objective: To explore the significance of serum neuron-specific enolase (NSE) and homocysteine (Hcy) levels in patients with acute cerebral infarction on the changes in the condition and clinical prognosis, and provide evidence for diagnosis and treatment of patients. Methods: One hundred and twenty patients with acute cerebral infarction admitted from January 2017 to December 2019 were included as the research subjects. During the same period, 100 healthy people were included as the control group. The serum NSE, D-dimer (DD), C-reactive protein (CRP) and Hcy levels of the two groups were observed. The differences in serum NSE, Hcy, DD and CRP levels of patients with different lesion areas and neurological deficits were compared. And the correlation between the above four indicators and the lesion area and neurological deficits was analyzed. Results: Serum Hcy, NSE, DD and CRP levels in the observation group were significantly higher than those in the control group. The differences were statistically significant (P<0.05); serum Hcy, NSE, DD, CRP levels in the small infarction group were lower than those in the middle infarction group and the large infarction group. The differences were statistically significant (P<0.05); the serum Hcy, NSE, DD and CRP levels of patients in the middle infarction group were lower than those in the large infarction group (P<0.05); the levels of Hcy, NSE, DD and CRP in the mild group were significantly lower than those in the moderate group and the severe group, and the levels of Hcy, NSE, DD and CRP in the moderate group were significantly lower than those in the severe group (P<0.05); serum Hcy, NSE, DD and CRP levels were significantly positively correlated with infarct size (r1=0.371, r2=0.408, r3=0.329, r4=0.510; P<0.05); serum Hcy, NSE, DD and CRP were positively correlated with the degree of neurological deficit (r1=0.551, r2=0.427, r3=0.291, r4=0.316; P<0.05). Conclusion: The levels of Hcy, NSE, DD, and CRP are closely related to the infarct size and neurological deficit in patients with acute cerebral infarction, and can be used as effective indicators to evaluate the progress and prognosis of acute cerebral infarction.
Keywords：
acute cerebral infarction; neuron-specific enolase; homocysteine; D-dimer; C-reactive protein