目的 觀察機(jī)械通氣治療對(duì)肺性腦病患者血清神經(jīng)元特異性烯醇化酶( NSE) 的影響。方法 21 例肺性腦病患者機(jī)械通氣前、機(jī)械通氣12 h 后及患者意識(shí)轉(zhuǎn)清時(shí)記錄其格拉斯哥昏迷評(píng)分( GCS) , 同時(shí)抽取外周靜脈血和動(dòng)脈血, 放射免疫法檢測(cè)血清NSE, 動(dòng)脈血?dú)夥治鰴z測(cè)PaCO2 和PaO2。結(jié)果 21 例肺性腦病患者在機(jī)械通氣12 h 后血清NSE 較械通氣前顯著降低[ ( 24. 54 ±6. 65) μg/L比( 28. 39 ±4. 85) μg/L, P lt; 0. 05] , GCS 評(píng)分較機(jī)械通氣前顯著升高[ ( 12. 00 ±2. 10) 分比( 9. 67 ±1. 28) 分, P lt;0. 01] , PaCO2 和PaO2 較機(jī)械通氣前均有顯著改善( P lt;0. 01) 。經(jīng)治療后意識(shí)轉(zhuǎn)清18 例, 未轉(zhuǎn)清3 例。18 例患者意識(shí)轉(zhuǎn)清時(shí)GCS 評(píng)分較機(jī)械通氣前好轉(zhuǎn)[ ( 12. 67 ±1. 53) 分,P lt;0. 01] , 血清NSE 水平進(jìn)一步降低[ ( 14. 19 ±2. 91) μg/L, P lt;0. 01] 。結(jié)論 血清NSE 檢測(cè)反映機(jī)械通氣治療后患者腦功能的改善, 可作為判斷預(yù)后的指標(biāo)。
引用本文： 崔可,徐穎鶴,林榮海,單仁飛,陳中騰. 機(jī)械通氣對(duì)肺性腦病患者血清神經(jīng)元特異性烯醇化酶的影響. 中國呼吸與危重監(jiān)護(hù)雜志, 2010, 9(3): 278-280. doi: 復(fù)制
| 1. | 劉菊英, 楊紅忠, 顏關(guān)明. 肺性腦病患者血清神經(jīng)元特異性烯醇化酶活性的研究. 湖南醫(yī)科大學(xué)學(xué)報(bào), 2000 , 25: 281 -282. |
| 2. | Lückl J, Farkas O, Pál J, et al. Protein biomarkers in experimental models and in clinical care of traumatic brain injury. Ideggyogy Sz,2007, 60: 284 -294. |
| 3. | Odagiri E. Neuron specific enolase. Nippon Rinsho, 2005, 63 Suppl 8 : 717-719. |
| 4. | Anand N, Stead LG. Neuron-specific enolase as a marker for acute ischemic stroke: a systematic review. Cerebrovasc Dis,2005,20: 213-219. |
| 5. | Nguyen DN, Spapen H, Su F, et al. Elevated serum levels of S-100 beta protein and neuron-specific enolase are associated with brain injury in patients with severe sepsis and septic shock. Crit Care Med,2006, 34: 1967-1974. |
| 6. | 陳紹平, 陳小兵, 劉立興, 等. 肺性腦病患者血清神經(jīng)元特異性烯醇化酶測(cè)定及臨床意義. 中國呼吸與危重監(jiān)護(hù)雜志, 2003,2:230-232. |
| 7. | 史玉泉, 周孝達(dá), 主編. 實(shí)用神經(jīng)病學(xué). 第3 版. 上海: 上?？茖W(xué)技術(shù)出版社, 2004 , 1375 -1376. |
- 1. 劉菊英, 楊紅忠, 顏關(guān)明. 肺性腦病患者血清神經(jīng)元特異性烯醇化酶活性的研究. 湖南醫(yī)科大學(xué)學(xué)報(bào), 2000 , 25: 281 -282.
- 2. Lückl J, Farkas O, Pál J, et al. Protein biomarkers in experimental models and in clinical care of traumatic brain injury. Ideggyogy Sz,2007, 60: 284 -294.
- 3. Odagiri E. Neuron specific enolase. Nippon Rinsho, 2005, 63 Suppl 8 : 717-719.
- 4. Anand N, Stead LG. Neuron-specific enolase as a marker for acute ischemic stroke: a systematic review. Cerebrovasc Dis,2005,20: 213-219.
- 5. Nguyen DN, Spapen H, Su F, et al. Elevated serum levels of S-100 beta protein and neuron-specific enolase are associated with brain injury in patients with severe sepsis and septic shock. Crit Care Med,2006, 34: 1967-1974.
- 6. 陳紹平, 陳小兵, 劉立興, 等. 肺性腦病患者血清神經(jīng)元特異性烯醇化酶測(cè)定及臨床意義. 中國呼吸與危重監(jiān)護(hù)雜志, 2003,2:230-232.
- 7. 史玉泉, 周孝達(dá), 主編. 實(shí)用神經(jīng)病學(xué). 第3 版. 上海: 上?？茖W(xué)技術(shù)出版社, 2004 , 1375 -1376.