血清神经元特异性烯醇化酶对癫痫发作和晕厥的鉴别诊断价值

摘要

Objective To examine whether serum neuron-specific enolase (NSE) has differential diagnostic value as a biochemical marker for seizure and syncope. Methods 80 seizure patients,80 syncope patients and 80 healthy controls in our study were selected. Blood sample were drew for three group subjects by ulnar vein within 12 h after loss of consciousness. Serum NSE level were measured by enzyme-linked immunosorbent assay ( ELISA). Results The NSE level was (15. 12 ± 7. 81) μg/L for seizure group, (10.98 ± 3. 54) μug/L for syncope group, (10. 35 ± 1. 79) μg/L for control group. Compared to syncope group and control group,serum NSE level was significantly increased in seizure group. There was no statistical difference between syncope group and control group. In order to define the optimal cut-off point with the highest diagnostic accuracy, we performed receiver operating characteristic (ROC) curve a-nalysis for distinct NSE serum concentrations. The highest area under the curve was calculated for a baseline serum NSE concentration of 11.55 ng/ml with a sensitivity of 0.59 and specificity of 0.90. Conclusion Serum NSE level is significantly increased after seizure, which indicates that has brain damage after seizure. Serum NSE measurement may be a helpful detect for differential diagnosis of seizure from syncope.%目的 探讨血清神经元特异性烯醇化酶(NSE)对癫痫发作和晕厥的鉴别诊断价值.方法 选择癫痫发作患者80例,晕厥患者80例,健康对照者80例,在患者发作性意识丧失后12小时内抽肘静脉血,应用双抗体夹心酶联免疫吸附法(ELISA)测定3组研究对象的血清NSE水平.结果 癫痫组患者血清NSE水平比晕厥组和对照组均明显升高(P＜0.05).晕厥组和对照组NSE值比较差异无统计学意义.癫痫组于癫痫发作后3小时血清NSE水平开始明显升高,6小时达高峰,之后逐渐下降,12小时仍高于正常.通过受试者工作特征(ROC)曲线分析,确定11.55μg/L的血清NSE浓度时曲线下面积最大,其敏感性是0.59,特异性是0.90.结论 癫痫发作后血清NSE水平显著升高,提示癫痫发作后存在脑损伤,测定血清NSE水平可能在癫痫发作与晕厥的鉴别诊断中具有临床指导意义.