急性脊髓損傷后患者血清中S100B蛋白和NSE的動(dòng)態(tài)變化及其意義
發(fā)布時(shí)間：2018-09-14 11:10
【摘要】：目的:觀察急性脊髓損傷(spinal cord injury,SCI)患者血清中S100B鈣結(jié)合蛋白(S100 calcium binding protein B,S100B)和神經(jīng)元特異性烯醇化酶(neuron-specific enolas,NSE)的動(dòng)態(tài)變化,并研究這兩種生化標(biāo)記物與脊髓損傷情況的相關(guān)性。方法:選取2014年10月至2016年10月,河北大學(xué)附屬醫(yī)院急診入院的脊髓損傷患者32例作為脊髓損傷組,脊髓神經(jīng)損傷功能的評(píng)定采用脊髓損傷神經(jīng)學(xué)分類(lèi)國(guó)際標(biāo)準(zhǔn)(ASIA,2011版本)[1]。同期河北大學(xué)附屬醫(yī)院入院的單純椎體骨折無(wú)神經(jīng)癥狀患者30例,為椎體骨折組,選取河北大學(xué)附屬醫(yī)院健康體檢者30人作為健康對(duì)照組。全部脊髓損傷組和椎體骨折組于傷后12h、24h、3d、7d、14d抽取靜脈血4ml。由于S100B蛋白和NSE主要存在中樞神經(jīng)系統(tǒng)中,正常生理狀態(tài)下血清中濃度比較平穩(wěn),所以健康對(duì)照組于清晨空腹抽取靜脈血4ml。用酶聯(lián)免疫吸附法(ELISA法)檢測(cè)血清中S100B蛋白和NSE含量。比較三組之間在不同時(shí)間點(diǎn)濃度的差異。結(jié)果:三組在傷后12h、24、3d、7d、14d測(cè)得的血清S100B蛋白和NSE組間比較有統(tǒng)計(jì)學(xué)意義,P0.05。脊髓損傷組與健康對(duì)照組比較均有統(tǒng)計(jì)學(xué)意義,P0.05,椎體骨折組與健康對(duì)照組比較有統(tǒng)計(jì)學(xué)意義,P0.05,脊髓損傷組與椎體骨折組比較有統(tǒng)計(jì)學(xué)意義,P0.05。脊髓損傷血清中S100B蛋白和NSE含量在脊髓損傷12h就有了升高,濃度高于正常對(duì)照組,在24小時(shí)達(dá)峰,與正常對(duì)照組比較有統(tǒng)計(jì)學(xué)意義,P0.05,隨著時(shí)間變化濃度也有波動(dòng),隨后濃度有所下降,約14天的時(shí)候降至較低水平,但仍然高于健康對(duì)照組。單純椎體骨折組其濃度也有所升高,約在第24小時(shí)測(cè)得峰值,與健康對(duì)照組相比差異有統(tǒng)計(jì)學(xué)意義,P0.05。但椎體骨折組各時(shí)間點(diǎn)的濃度卻遠(yuǎn)低于脊髓損傷組,兩組各時(shí)間點(diǎn)濃度比較有統(tǒng)計(jì)學(xué)意義,P0.05。結(jié)論:(1)脊髓損傷后患者血清中S100B蛋白和NSE濃度有所升高,24h達(dá)峰,然后血清中這兩種生化指標(biāo)的濃度有下降趨勢(shì),約14d降至較低水平,隨時(shí)間節(jié)點(diǎn)變化呈現(xiàn)出動(dòng)態(tài)變化。表明神經(jīng)元細(xì)胞受損后釋放的S100B和NSE也在第24h達(dá)到高峰,約第14d后基本釋放完畢�？梢杂糜谠缙诒O(jiān)測(cè)病情變化。(2)椎體骨折患者血清中S100B蛋白和NSE也有所升高,但脊髓損傷組各時(shí)間點(diǎn)濃度遠(yuǎn)高于椎體骨折組,差異有統(tǒng)計(jì)學(xué)意義,這兩種指標(biāo)能夠反映出脊髓損傷的情況。
[Abstract]:Aim: to observe the dynamic changes of serum S100B calcium binding protein (S100 calcium binding protein BnS100B) and neuron-specific enolase (neuron-specific enolas,NSE) in patients with acute spinal cord injury (spinal cord injury,SCI), and to investigate the correlation between the two biochemical markers and spinal cord injury. Methods: from October 2014 to October 2016, 32 patients with spinal cord injury (sci) admitted to the hospital of Hebei University were selected as the spinal cord injury group. The function of spinal cord nerve injury was evaluated by the International Standard for Classification of Spinal Cord injury (ASIA,2011 version) [1]. In the same period, 30 patients with simple vertebral fracture without neurological symptoms were admitted to the affiliated Hospital of Hebei University, which were treated as vertebral fracture group. 30 healthy persons in Hebei University affiliated Hospital were selected as the healthy control group. Venous blood was taken from all the spinal cord injury group and vertebral body fracture group at 12 h after injury, 24 h after injury and 3 days after injury for 7 d and 14 d after injury. Because S100B protein and NSE mainly exist in the central nervous system and the serum concentration in normal physiological state is relatively stable, so the healthy control group draws the venous blood 4 ml on an empty stomach in the morning. Enzyme linked immunosorbent assay (ELISA) was used to detect the content of S100B protein and NSE in serum. The difference of concentration between the three groups at different time points was compared. Results: the serum S100B protein in the three groups was significantly higher than that in the NSE group (P 0.05). The spinal cord injury group compared with the healthy control group had statistical significance (P 0.05), the vertebral body fracture group had statistical significance compared with the healthy control group (P 0.05), the spinal cord injury group and the vertebral body fracture group had statistical significance (P 0.05). The content of S100B protein and NSE in the serum of spinal cord injury increased at 12 h after spinal cord injury, and the concentration was higher than that in the normal control group, and reached the peak at 24 hours. Compared with the normal control group, the content of S100B protein and NSE was significantly higher than that of the normal control group (P 0.05), and the concentration fluctuated with time. Concentrations then declined, reaching lower levels at about 14 days, but still higher than in healthy controls. The concentration of simple vertebral fracture group also increased, about 24 hours after the peak measured, compared with the healthy control group, the difference was statistically significant (P 0.05). However, the concentration at each time point in the vertebral fracture group was much lower than that in the spinal cord injury group, and there was a significant difference between the two groups in the concentration at each time point (P 0.05). Conclusion: (1) the concentrations of S100B protein and NSE in the serum of patients with spinal cord injury increased to a peak at 24 hours, then the concentration of these two biochemical indexes decreased to a lower level at about 14 days, and showed dynamic changes with the change of time nodes. The results showed that the release of S100B and NSE reached its peak at 24 h after injury, and the release of S100B and NSE was almost completed on the 14th day. (2) the serum S100B protein and NSE in the patients with vertebral fracture were also increased, but the concentration of S100B protein and NSE in the spinal cord injury group was much higher than that in the vertebral fracture group, and the difference was statistically significant. These two indicators can reflect the condition of spinal cord injury.
【學(xué)位授予單位】：河北大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R651.2
本文編號(hào)：2242536
[Abstract]:Aim: to observe the dynamic changes of serum S100B calcium binding protein (S100 calcium binding protein BnS100B) and neuron-specific enolase (neuron-specific enolas,NSE) in patients with acute spinal cord injury (spinal cord injury,SCI), and to investigate the correlation between the two biochemical markers and spinal cord injury. Methods: from October 2014 to October 2016, 32 patients with spinal cord injury (sci) admitted to the hospital of Hebei University were selected as the spinal cord injury group. The function of spinal cord nerve injury was evaluated by the International Standard for Classification of Spinal Cord injury (ASIA,2011 version) [1]. In the same period, 30 patients with simple vertebral fracture without neurological symptoms were admitted to the affiliated Hospital of Hebei University, which were treated as vertebral fracture group. 30 healthy persons in Hebei University affiliated Hospital were selected as the healthy control group. Venous blood was taken from all the spinal cord injury group and vertebral body fracture group at 12 h after injury, 24 h after injury and 3 days after injury for 7 d and 14 d after injury. Because S100B protein and NSE mainly exist in the central nervous system and the serum concentration in normal physiological state is relatively stable, so the healthy control group draws the venous blood 4 ml on an empty stomach in the morning. Enzyme linked immunosorbent assay (ELISA) was used to detect the content of S100B protein and NSE in serum. The difference of concentration between the three groups at different time points was compared. Results: the serum S100B protein in the three groups was significantly higher than that in the NSE group (P 0.05). The spinal cord injury group compared with the healthy control group had statistical significance (P 0.05), the vertebral body fracture group had statistical significance compared with the healthy control group (P 0.05), the spinal cord injury group and the vertebral body fracture group had statistical significance (P 0.05). The content of S100B protein and NSE in the serum of spinal cord injury increased at 12 h after spinal cord injury, and the concentration was higher than that in the normal control group, and reached the peak at 24 hours. Compared with the normal control group, the content of S100B protein and NSE was significantly higher than that of the normal control group (P 0.05), and the concentration fluctuated with time. Concentrations then declined, reaching lower levels at about 14 days, but still higher than in healthy controls. The concentration of simple vertebral fracture group also increased, about 24 hours after the peak measured, compared with the healthy control group, the difference was statistically significant (P 0.05). However, the concentration at each time point in the vertebral fracture group was much lower than that in the spinal cord injury group, and there was a significant difference between the two groups in the concentration at each time point (P 0.05). Conclusion: (1) the concentrations of S100B protein and NSE in the serum of patients with spinal cord injury increased to a peak at 24 hours, then the concentration of these two biochemical indexes decreased to a lower level at about 14 days, and showed dynamic changes with the change of time nodes. The results showed that the release of S100B and NSE reached its peak at 24 h after injury, and the release of S100B and NSE was almost completed on the 14th day. (2) the serum S100B protein and NSE in the patients with vertebral fracture were also increased, but the concentration of S100B protein and NSE in the spinal cord injury group was much higher than that in the vertebral fracture group, and the difference was statistically significant. These two indicators can reflect the condition of spinal cord injury.
【學(xué)位授予單位】：河北大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R651.2
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