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血清神经元特异性烯醇化酶可能是预测脑静脉血栓形成严重程度和结局的标志物。

Serum neuron specific enolase may be a marker to predict the severity and outcome of cerebral venous thrombosis.

机构信息

Departments of Neurology, Neurosurgery, Ophthalmology and Emergency, Xuanwu Hospital, Capital Medical University, Beijing Institute for Brain Disorders, Beijing, 100053, China.

Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, 48201, USA.

出版信息

J Neurol. 2018 Jan;265(1):46-51. doi: 10.1007/s00415-017-8659-9. Epub 2017 Nov 11.

Abstract

The objective is to explore the effective of baseline serum neuron specific enolase (NSE) on predicting the severity and outcome in patients with cerebral venous thrombosis (CVT). A total of 156 patients confirmed as CVT in Xuanwu Hospital were enrolled in this retrospective study from March 2011 through September 2016. The severity was evaluated with the National Institutes of Health Stroke Score (NIHSS), intracranial pressure (ICP), and CVT-related complications; the outcome was evaluated by modified Rankin Scale (mRS); the relationship between baseline serum NSE and mRS was analyzed with receiver operating characteristic curve (ROC), logistic regression analysis, and Kaplan-Meier curves. Baseline level of serum NSE was positively associated with baseline NIHSS (r = 0.322, p < 0.001). Among which, patients with high level of serum NSE were also noticed with cerebral venous infarction (p < 0.001), intracranial hemorrhage (p < 0.001), seizure (p = 0.035). Meanwhile, patients in NSE ≥ 15.05 ng/mL group vs. NSE < 15.05 ng/mL group had large mRS scores (≥ 3) at discharge (adjusted OR: 5.40, 95% CI 1.27-22.91; p = 0.022) and higher percentage of mRS scores ≥ 3 during 40 months of outpatient follow-up (log-rank p < 0.001). Baseline level of serum NSE is positively associated with the severity of CVT. Presumably NSE may be a potential predictor for the clinical outcome of CVT.

摘要

目的是探讨基线血清神经元特异性烯醇化酶(NSE)对预测脑静脉血栓形成(CVT)患者严重程度和结局的有效性。本回顾性研究共纳入 2011 年 3 月至 2016 年 9 月期间在宣武医院确诊为 CVT 的 156 例患者。采用美国国立卫生研究院卒中量表(NIHSS)、颅内压(ICP)和 CVT 相关并发症评估严重程度,采用改良 Rankin 量表(mRS)评估结局,通过受试者工作特征曲线(ROC)、Logistic 回归分析和 Kaplan-Meier 曲线分析基线血清 NSE 与 mRS 的关系。基线血清 NSE 水平与基线 NIHSS 呈正相关(r=0.322,p<0.001)。其中,高水平血清 NSE 的患者还伴有脑静脉梗死(p<0.001)、颅内出血(p<0.001)和癫痫发作(p=0.035)。同时,NSE≥15.05ng/mL 组与 NSE<15.05ng/mL 组出院时 mRS 评分(≥3)较大(调整 OR:5.40,95%CI 1.27-22.91;p=0.022),40 个月门诊随访时 mRS 评分(≥3)的比例较高(对数秩检验 p<0.001)。基线血清 NSE 水平与 CVT 的严重程度呈正相关。NSE 可能是 CVT 临床结局的潜在预测因子。

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