CAJ | 학술논문

目的：探讨血清神经元特异性烯醇化酶（ NSE）、S100β蛋白、神经胶质纤维酸性蛋白（GFAP）、髓鞘碱性蛋白（MBP）联合检测在早期脑挫裂伤患者诊断中的价值。方法研究对象来源于我院2012年4月至2013年7月住院治疗的112例脑挫裂伤患者，脑挫裂伤患者均经头颅 CT 或 MRI 明确诊断，其中轻型颅脑损伤68例，重型颅脑损伤44例。正常对照83名均来自健康体检人群，排除肺部疾病及其他神经系统疾病。采用电化学发光法检测血清 NSE 和 ELISA 法检测血清 S100β蛋白、GFAP、MBP 浓度，并进行组间的比较。结果轻型组患者血清 NSE、S100β蛋白、GFAP、MBP 浓度分别为（18.14±6.83）、（0.92±0.45）、（0.78±0.37）、（4.37±1.84）μg/ L，重型组分别为（32.11±12.48）、（1.58±0.94）、（4.26±1.96）、（14.72±6.77）μg/ L，正常对照组分别为（8.94±3.49）、（0.12±0.08）、（0.13±0.09）、（1.98±0.89）μg/ L，轻、重型颅脑损伤组与正常对照组间比较差异均有统计学意义（ F值分别为137.520、120.083、283.727、205.569，P 均＜0.01）；正常对照组与轻型颅脑损伤组比较，差异均有统计学意义（q 值分别为10.599、13.296、5.881、6.018，P 均＜0.01）；轻、重型颅脑损伤组比较，差异均有统计学意义（q 值分别为13.600、9.249、26.639、22.029，P 均＜0.01）；正常对照组与重型颅脑损伤组比较，差异均有统计学意义（q 值分别为23.408、21.258、32.797、28.134，P 均＜0.01）。结论血清 NSE、S100β蛋白、GFAP、MBP 水平联合检测可以作为早期脑挫裂伤诊断及评估损伤程度的辅助指标。
목적：탐토혈청신경원특이성희순화매（ NSE）、S100β단백、신경효질섬유산성단백（GFAP）、수초감성단백（MBP）연합검측재조기뇌좌렬상환자진단중적개치。방법연구대상래원우아원2012년4월지2013년7월주원치료적112례뇌좌렬상환자，뇌좌렬상환자균경두로 CT 혹 MRI 명학진단，기중경형로뇌손상68례，중형로뇌손상44례。정상대조83명균래자건강체검인군，배제폐부질병급기타신경계통질병。채용전화학발광법검측혈청 NSE 화 ELISA 법검측혈청 S100β단백、GFAP、MBP 농도，병진행조간적비교。결과경형조환자혈청 NSE、S100β단백、GFAP、MBP 농도분별위（18.14±6.83）、（0.92±0.45）、（0.78±0.37）、（4.37±1.84）μg/ L，중형조분별위（32.11±12.48）、（1.58±0.94）、（4.26±1.96）、（14.72±6.77）μg/ L，정상대조조분별위（8.94±3.49）、（0.12±0.08）、（0.13±0.09）、（1.98±0.89）μg/ L，경、중형로뇌손상조여정상대조조간비교차이균유통계학의의（ F치분별위137.520、120.083、283.727、205.569，P 균＜0.01）；정상대조조여경형로뇌손상조비교，차이균유통계학의의（q 치분별위10.599、13.296、5.881、6.018，P 균＜0.01）；경、중형로뇌손상조비교，차이균유통계학의의（q 치분별위13.600、9.249、26.639、22.029，P 균＜0.01）；정상대조조여중형로뇌손상조비교，차이균유통계학의의（q 치분별위23.408、21.258、32.797、28.134，P 균＜0.01）。결론혈청 NSE、S100β단백、GFAP、MBP 수평연합검측가이작위조기뇌좌렬상진단급평고손상정도적보조지표。
Objective To investigate the diagnostic value of nuron specific enolase( NSE),S100βprotein,glial fibrillary acidic protein( GFAP)and myelin basic protein( MBP)in patients with early brain contusion and laceration. Methods One hundred and twelve cases with brain contusion and laceration diagnosed by CT or MRI were selected as our subjects who hospitalized Harrison international peace hospital from Apr. 2012 to Jul. 2013. Of them,68 cases with mild head injury were served as mild group and 44 cases of severe traumatic brain injury were served as severe group. And 83 healthy people without lung disease and nervous system diseases were served as control group. Electro chemiluminescence assay and ELISA methods were used to measure the level of NSE,S100β,GFAP,MBP. Results the level of serum NSE,S100β protein,GFAP and MBP in mild group were(18. 14 ± 6. 83),(0. 92 ± 0. 45),(0. 78 ± 0. 37))(4. 37 ± 1. 84)μg/ L,respectively, and(32. 11 ± 12. 48),(1. 58 ± 0. 94),(4. 26 ± 1. 96),(14. 72 ± 6. 77)μg/ L,respectively in severe group, and(8. 94 ± 3. 49),(0. 12 ± 0. 08),(0. 13 ± 0. 09),(1. 98 ± 0. 89)μg/ L,respectively in control group. There were significant differences among three groups( F = 137. 520,120. 083,283. 727,205. 569 respectively;P< 0. 01). All indexes were different between control and mild groups( q = 10. 599,13. 296,5. 881,6. 018;P< 0. 01),as well as between the mild and severe groups(q = 13. 600,9. 249,26. 639,22. 029;P < 0. 01),and between control and severe group(q = 23. 408,21. 258,32. 797,28. 134;P < 0. 01). Conclusion The level of serum NSE,S100β,GFAP,MBP can be used as early indicators of brain injury secondary diagnosis and secondary index for evaluating damage degree.