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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)联合检测对颅脑损伤患者早期进行预后判断的价值。方法: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;选择健康体检人员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)。脑损伤各组较之对照组血清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)。脑损伤各组较之对照组血清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)。通过受试者工作特征曲线分析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,值得临床推广应用。
Objective: To investigate the value of combined detection of serum astrocyte-derived protein (S100B) and neuron-specific enolase (NSE) in early prognosis of patients with craniocerebral injury. Methods: One hundred and twenty-two patients with craniocerebral trauma who were admitted to our hospital were divided into three groups according to Glasgow score (GCS) and GOS score one month after injury. Forty-two healthy subjects were selected as control group. Serum levels of S100B and NSE were measured by enzyme-linked immunosorbent assay. Results: The serum levels of S100B and NSE in different groups were significantly different (P <0.01). Compared with the control group, the levels of S100B and NSE in brain injury group were significantly increased (P <0.01). Serum levels of S100B and NSE in critically ill patients were positively correlated (P <0.01). The positive rates of S100B and NSE in the brain injury groups were significantly higher than those in the control group (P <0.001). The positive rate of NSE in severe group was significantly higher than that in mild group and moderate group (P <0.001). S100B and NSE were both sensitive to craniocerebral injury, and both S100B and NSE had a higher predictive value for the prognosis of patients with craniocerebral injury. NSE and S100B joint detection, the sensitivity was 86%, specificity was 74%, were higher than a single indicator test (P <0.05). Conclusion: The combined detection of serum S100B and NSE is of great significance in prognosis of patients with craniocerebral injury, which is worthy of clinical application.