低血糖脑病患者外周血清S100β蛋白和神经元特异性烯醇化酶测定及意义

摘要

目的 探讨低血糖脑病(hypoglycemic encephalopathy,HE)患者外周血清中神经生化标志物S100β蛋白和神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平与神经功能损害程度的相关性.方法 纳入HE患者62例(研究组),以及年龄、性别与之匹配的健康志愿者62例(对照组).搜集受试者的一般资料和疾病信息.应用酶联免疫吸附试验(ELISA)检测两组受试者外周血清中S100β蛋白和NSE的表达水平.分析低血糖持续时间对HE患者血清S100β蛋白和NSE表达水平的影响.采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)对治疗后3 m HE患者的神经功能进行综合评分.分析HE患者血清S100 β蛋白和NSE表达水平与血糖水平、低血糖持续时间、NIHSS评分的相关性,分析NIHSS评分与血糖水平、低血糖持续时间的相关性.结果 研究组血清S100β蛋白和NSE表达水平显著高于正常对照组(P<0.01).随着低血糖持续时间延长,HE患者外周血清S100β蛋白和NSE表达水平持续升高,至24 h后基本达峰值(P<0.05).HE患者血清S100β蛋白和NSE表达水平与血糖水平呈负相关(P<0.05),与低血糖持续时间呈正相关(P<0.05),与NIHSS评分呈正相关(P<0.05).NIHSS评分与血糖水平呈负相关(P<0.05),与低血糖持续时间呈正相关(P<0.05).结论 HE患者外周血清中S100β蛋白和NSE的表达水能在一定程度上反映患者神经功能损害的程度,对HE的诊断及预后的判断有一定参考价值.%Objective To investigate the relationship between the levels of nerve biochemical markers of S100β protein and neuron specific enolase (NSE) in peripheral blood of patients with hypoglycemic encephalopathy (HE) and degree of neurological impairment.Methods 102 HE patients (study group) and 62 age and sex matched healthy volunteers (control group) were recruited in the present study.The general information and disease information of the subjects were collected.The expression of S100β protein and NSE was detected by enzyme-linked immunosorbent assay (ELISA).To analyze the influence of duration of hypoglycemia on the expression of S100β protein and NSE in serum of patients with HE.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the neurological function of HE patients at three months after treatment.To analyze the correlation between the levels of serum S100β protein and NSE in patients with HE and the level of blood glucose,duration of hypoglycemia,NIHSS score,and to analyze the correlation between NIHSS score and blood glucose level and duration of hypoglycemia.Results The expression level of serum S100β protein and NSE in the study group was significantly higher than that in the normal control group (P< 0.01).With the prolonged duration of hypoglycemia,the expression of S100β protein and NSE in peripheral blood of patients with HE continued to rise to a peak of 24 hours (P<0.05).The expression level of S100β protein and NSE in serum of patients with HE was negatively correlated with blood glucose level (P<0.05),which was positively correlated with the duration of hypoglycemia (P<0.05),which was positively correlated with NIHSS score (P<0.05).NIHSS score was negatively correlated with blood glucose level (P<0.05),and was positively correlated with duration of hypoglycemia (P<0.05).Conclusion The expression of S100β protein and NSE in peripheral blood can reflect the degree of nerve function damage of HE patients to a certain extent,and has certain reference value for the diagnosis and prognosis of HE.