[缺血性脑卒中急性期及早期恢复期康复阶段神经元特异性烯醇化酶和脑源性神经营养因子水平的评估]
[Assessment of the levels of neuron-specific enolase and BDNF at the stages of rehabilitation in the acute and early recovery periods of ischemic stroke].
作者信息
Koroleva E S, Brazovskaya N G, Levchuk L A, Kazakov S D, Romadina N Y, Alifirova V M
机构信息
Siberian State Medical University, Tomsk, Russia.
Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia.
出版信息
Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(8. Vyp. 2):30-36. doi: 10.17116/jnevro202012008230.
BACKGROUND
The issue of the diagnostic significance and clinical value of neuron-specific enolase (NSE) and brain-derived neurotropic factor (BDNF) in the acute period of stroke remains controversial. Therefore, it is advisable to study the correlation of biomarkers with the clinical characteristics of stroke in the time period of early recovery.
OBJECTIVE
To monitor NSE and BDNF levels in peripheral blood, to analyze the clinical and laboratory correlations in patients with ischemic stroke at the stages of medical rehabilitation in the early recovery period.
MATERIAL AND METHODS
Forty-nine patients with ischemic stroke in the middle cerebral artery were examined. The observation period is 90 days. Observation Points are Day 1; Day 14; Day 45; Day 90. The National Institute of Health Stroke Scale (NIHSS), the Fugle-Meyer Scale (FMA), the Modified Rankin Scale (mRS) were administered. NSE was determined in blood serum by enzyme-linked immunosorbent assay, BDNF was analyzed on a multiplex analyzer.
RESULTS AND CONCLUSION
NSE in patients was significantly higher than in the comparison group (<0.001) with a trend to a maximum decrease on the 90th day of stroke (<0.001). BDNF turned out to be lower than in the comparison group (=0.006) and significantly increased by the 14th day of the stroke (<0.001; =0.637). A negative correlation was found between a decrease in NSE and an increase in BDNF (= -0.349; =0.05). A positive correlation was found between an increase in BDNF and a decrease in mRS scores (=0.499, =0.035). Outcomes in patients in group 1 (after stages I and II of rehabilitation) on the assessment scales were significantly better than in patients discharged after stage I for outpatient monitoring - group 2 (<0.05). In group 1, BDNF did not differ from BDNF (=0.17), and in group 2 it was significantly lower by the end of the early recovery period (=0.002).
背景
神经元特异性烯醇化酶（NSE）和脑源性神经营养因子（BDNF）在卒中急性期的诊断意义及临床价值问题仍存在争议。因此，研究生物标志物与卒中早期恢复阶段临床特征的相关性是可取的。
目的
监测外周血中NSE和BDNF水平，分析早期恢复阶段医疗康复期缺血性卒中患者的临床与实验室相关性。
材料与方法
对49例大脑中动脉缺血性卒中患者进行检查。观察期为90天。观察点为第1天；第14天；第45天；第90天。采用美国国立卫生研究院卒中量表（NIHSS）、Fugle-Meyer量表（FMA）、改良Rankin量表（mRS）进行评估。采用酶联免疫吸附测定法测定血清中的NSE，在多通道分析仪上分析BDNF。
结果与结论
患者的NSE显著高于对照组（<0.001），在卒中第90天有降至最低的趋势（<0.001）。BDNF低于对照组（=0.006），在卒中第14天显著升高（<0.001；=0.637）。发现NSE降低与BDNF升高之间存在负相关（= -0.349；=0.05）。发现BDNF升高与mRS评分降低之间存在正相关（=0.499，=0.035）。在评估量表上，第1组（康复I期和II期后）患者的结果明显优于第I期后出院进行门诊监测的患者 - 第2组（<0.05）。在第1组中，BDNF与BDNF无差异（=0.17），在第2组中，在早期恢复期末显著降低（=0.002）。
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