神经元特异性烯醇化酶预测恶性大脑中动脉供血区梗死的准确性

被引：6

作者：

李霞

宿英英

张运周

王琳

刘甜甜

机构：

[1] 首都医科大学宣武医院神经内科重症监护病房

来源：

国际脑血管病杂志 | 2011年 / 02期

关键词：

神经元; 磷酸丙酮酸水合酶; 生物学标记; 脑梗死; 梗死,大脑中动脉; 磁共振成像; 试验预期值; 危险性评估;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

100204 [神经病学];

摘要：

目的探讨血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)预测恶性大脑中动脉供血区梗死(malignant middle cerebral artery infarction,mMCAI)的准确性。方法纳入40例发病24 h内的急性大面积脑梗死患者,在发病后24、36和48h抽取血液样本,采用罗氏全自动电化学发光仪测定血清NSE浓度。mMCAI定义为临床出现脑疝征象且CT和(或)MRI显示占位效应。采用受试者工作特征曲线分析3个时间点血清NSE水平预测mMCAI的准确性。结果 16例患者发生mMCAI(40%)。发病后24 h血清NSE水平预测mMCAI的准确性较差;36 h血清NSE浓度预测mMCAI的特异性很高(96%),但敏感性较低(69%);48 h血清NSE浓度预测mMCAI的特异性(92%)和敏感性(88%)均很高。结论血清NSE浓度及其动态变化可预测mMCAI的发生,预测时间点以发病后36～48 h为宜。

引用

共 8 条

[1]

Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials [J].

Vahedi, Katayoun ;

Hofmeijer, Jeannette ;

Juettler, Eric ;

Vicaut, Eric ;

George, Bernard ;

Algra, Ale ;

Amelink, G. Johan ;

Schmiedeck, Peter ;

Schwab, Stefan ;

Rothwell, Peter M. ;

Bousser, Marie-Germaine ;

van der Worp, H. Bart ;

Hacke, Werner .

LANCET NEUROLOGY, 2007, 6 (03) :215-222

[2]

Neuron-specific enolase and tau protein as neurobiochemical markers of neuronal damage are related to early clinical course and long-term outcome in acute ischemic stroke [J].

Wunderlich, Michael T. ;

Lins, Hartmut ;

Skalej, Martin ;

Wallesch, Claus-W. ;

Goertler, Michael .

CLINICAL NEUROLOGY AND NEUROSURGERY, 2006, 108 (06) :558-563

[3]

The prediction of malignant cerebral infarction by molecular brain barrier disruption markers [J].

Serena, J ;

Blanco, M ;

Castellanos, M ;

Silva, Y ;

Vivancos, J ;

Moro, MA ;

Leira, R ;

Lizasoain, I ;

Castillo, J ;

Dávalos, A .

STROKE, 2005, 36 (09) :1921-1926

[4]

Serum S100B predicts a malignant course of infarction in patients with acute middle cerebral artery occlusion [J].

Foerch, C ;

Otto, B ;

Singer, OC ;

Neumann-Haefelin, T ;

Yan, B ;

Berkefeld, J ;

Steinmetz, H ;

Sitzer, M .

STROKE, 2004, 35 (09) :2160-2164

[5]

Mortality of space-occupying ('malignant') middle cerebral artery infarction under conservative intensive care [J].

Berrouschot, J ;

Sterker, M ;

Bettin, S ;

Koster, J ;

Schneider, D .

INTENSIVE CARE MEDICINE, 1998, 24 (06) :620-623

[6]

NEURON-SPECIFIC ENOLASE CONCENTRATIONS IN BLOOD AS A PROGNOSTIC PARAMETER IN CEREBROVASCULAR DISEASES [J].

SCHAARSCHMIDT, H ;

PRANGE, HW ;

REIBER, H .

STROKE, 1994, 25 (03) :558-565

[7]

Neuron Specific Enolase; A Clinically Useful Marker for Neurons and Neuroendocrine Cells.[J].P J Marangos;D E Schmechel.Annual Review of Neuroscience.1987,

[8]

Predictors oflife-threatening brain edema in middle cerebral artery in-farction..Hofmeijer J;Algra A;Kappelle L J;et al;.Cerebrovascular Diseases.2008, 01

← 1 →