脑出血患者血清NSE、GFAP、BDNF水平变化与认知障碍相关性研究

摘要

Objective To investigate the serum neuron specific enolase(NSE)and glial fibrillary acidic protein(GFAP), brain derived neural nutrition factor(BDNF)level changes in cerebral hemorrhage patients and the correlation with cognitive impairment. Method 100 cases of acute spontaneous cerebral hemorrhage were selected, and the corresponding treatments were given in the hospital, the seru NSE, GFAP and BDNF were detected. 100 patients were divided into cognitive impairment group(57cases)and non cognitive impairment group(43cases) according to whether there were cognitive impairment. Those three indicators were compared between different levels of cognitive injury(MMSE score)group, and the correlation between the three indicators and MMSE. Results The serum GFAP and NSE were significantly higher in the patients with cognitive impairment than those without cognitive impairment, and BDNF was significantly lower(t=7.039,t=2.247,t=4.847,P<0.01). The serum levels of NSE, GFAP and BDNF were significantly different in the mild injury group, moderate injury group and severe injury group (F=22.752, F=31.506, F=38.294, P<0.01). The levels of serum NSE and GFAP were positively correlated with MMSE scores(r=0.641, r=0.604, P<0.05), and BDNF was negatively correlated with MMSE scores(r=0.582, P<0.05). Conclusion The levels of serum NSE, GFAP and BDNF in patients with cerebral hemorrhage are closely related to cognitive dysfunction after stroke, which can be used to determine the severity of cognitive impairment in patients with cerebral hemorrhage.%目的：探讨脑出血患者血清神经元特异性烯醇化酶（NSE）、胶质纤维酸性蛋白（GFAP）、脑源性神经营养因子（BDNF）水平变化与认知障碍相关性。方法选择急性自发性脑出血患者100例，入院时均给予相应治疗，并进行 NSE、GFAP、BDNF 检测。将100例患者依据是否发生认知障碍分为认知障碍组（57例）和无认知障碍组（43例）。并比较不同损伤水平（MMSE 评分）患者三个指标之间的差异、计算三个指标与 MMSE 水平的相关性。结果认知功能障碍组患者血清 NSE、GFAP 水平均显著高于无认知功能障碍组，BDNF 显著低于无认知功能障碍组（t=7.039，t=2.247，t=4.847，P<0.01）。轻度损伤组、中度损伤组和重度损伤组间血清 NSE、GFAP、BDNF 水平存在显著差异（F=22.752，F=31.506，F=38.294，P<0.01）。血清 NSE、GFAP 水平与 MMSE 评分正相关（r=0.641，r=0.604，P<0.05），BDNF 与 MMSE 评分负相关（r=0.582， P<0.05）。结论脑出血患者血清 NSE、GFAP、BDNF 水平与脑出血患者卒中后认知功能障碍密切相关，可用于判断脑出血患者认知功能障碍的严重程度。