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1、弥漫性轴突损伤患者血清S100B和神经元特异性烯醇化酶的变化及意义作者：顾建军，鲁峻，高广忠，张勤，蒋霖【摘要】目的：探计弥漫性轴突损伤(diffuseaxonalinjury,DAI)患者血清S100B和神经元特异性烯醇化酶(neuronspecifisenolase,NSE)浓度的变化及临床意义。方法:选择符合DAI诊断标准的脑外伤患者46例,对照组为同期受伤20例单纯头皮挫裂伤,无失血性休克患者.按照格拉斯哥预后评分Ⅰ~Ⅲ级（死亡，植物生存，严重残残）为预后不良组18例；Ⅳ-Ⅴ级（轻-中度致残和完全恢复）为预后良好组28例；于损后1h,3h,6h,12h,24h和48h采血检测血清
2、中S100B和NSE浓度。结果：与对照组比较，DAI组S100B蛋白在伤后1h就明显增高（P＜0.01），并持续升高至伤后6h,但预后良好组12～24h有所下降（P＞0.05），48h下降有统计学意义（P＜0.05）；预后不良组S100B蛋白持续不下降。而NSE于伤后3h开始升高（P＜0.05），6h达高峰（P＜0.01），预后良好组12h下降（P＜0.01），24h降至正常；预后不良组NSE持续不下降。结论：DAI患者血清S100B蛋白和NSE含量明显升高，联合监测血清S100B和NSE蛋白含量的变化不但能准确地反映出脑损害和程度而且可以判断DAI的预后。【关键词】弥漫性轴突损伤；S1
3、00B；神经元特异性烯醇化酶；酶联免疫吸附试验Changesofserumneuron-specificenolase(NSE)andS100Binheadtraumapatients[Abstract]Objective:Toinvestigatethechangesofserumneuron-specificenolase(NSE)andS100Binheadtraumapatientswithdiffuseaxonalinjury(DAI)andtheirclinicalsignificance.Mehtods:Forty-sixcasesofDAIwereselectedacco
4、rdingtodiagnosticcriteriaofDAI.Thecontrolgroupcontained20caseswithsimplescalplaceratedwound,andnoneofthemhadhemorrhagicshock.Theprognosisof18patientswithⅠ~ⅢofGlasgowprognosisscore(died,plantstatusandseriousmutilation)wasconsideredunfavourable,andthetheprognosisof28patientswithⅣ~Ⅴ(middletomoderate
5、mutilationorcompleterecovery)wasconsideredfavourable.ThelevelsofNSEandS100Binallpatientsweredetectedathours1,3,6,12,24and48aftertrauma.Results:ThelevelsofS100BwereobviouslyhigherinthegroupofDAI,comparedwithcontrolgroupat1hourfollowingheadtrauma(P<0.01),andcontinuelyhigherwithin6h,butthelevelso
6、fS100Bweredecreasedinpatientswithwellprognosis(P＞0.05)andthey4presentedstatisticalsignificanceat48h.ThelevelsofS100Binpatientswithbadprognosiswerenotdecreased,andthelevelsofNSEwereobviouslyhigherat3hfollowingheadtrauma(P<0.05),whichpeakedat6h(P<0.01),whileinpatientswithwellprognosisthelevel
7、sofNSEweredecreasedat12hfollowingheadtrauma(P<0.01)andtheyreachednormallevelat48h.ThelevelsofNSEinpatientswithbadprognosiswerenotdecreased.Conclusion:ThelevelsofNSEandS100Binserumareelevatedobviouslyinheadtraumapati
