Kuroiwa T, Tanabe H, Takatsuka H, Arai M, Nagasawa S, Ohta T
Osaka Mishima Critical Care Medical Center.
No Shinkei Geka. 1993 Nov;21(11):1021-4.
Enolase is an enzyme involved in glycolysis and neurospecific enolase (NSE) has two types of isoenzyme (alpha gamma and gamma gamma enolase). Found in nerve cells and axons, the NSE is reported to be released into the serum and cerebrospinal fluid following nerve injury. We recently analyzed serum NSE levels in 47 patients with solitary head injury who were transported to our center immediately after injury. There were 35 men and 12 women, with a mean age of 35.1 years. In each case, blood was sampled within 8 hours after injury. Serum NSE was measured and analyzed in relation to the level of consciousness (Japan Coma Scale) upon admission, the modified Araki's classification, the presence or absence of skull fracture, findings from computed tomography (CT) scans and the prognosis according to the Glasgow outcome scale. Differences were compared by t-test to determine significance. When the level of consciousness was compared with the serum NSE level upon admission, the NSE level was significantly higher in patients showing a three digit code disturbance of consciousness than in the other patients (p < 0.005). When NSE was analyzed in relation to the modified Araki's classification, the NSE level for the prolonged type with focal signs was higher than the NSE level for any other type (p < 0.001 compared to the transient type). The NSE level was significantly higher in patients with skull fracture than in patients without skull fracture (p < 0.01). The NSE level was significantly higher in patients showing contusion on CT scans than in patients without contusion (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
烯醇化酶是一种参与糖酵解的酶,神经特异性烯醇化酶(NSE)有两种同工酶类型(αγ和γγ烯醇化酶)。据报道,NSE存在于神经细胞和轴突中,在神经损伤后会释放到血清和脑脊液中。我们最近分析了47例单独头部受伤患者的血清NSE水平,这些患者在受伤后立即被送往我们中心。其中男性35例,女性12例,平均年龄35.1岁。在每种情况下,受伤后8小时内采集血液样本。测量血清NSE,并根据入院时的意识水平(日本昏迷量表)、改良荒木分类、是否存在颅骨骨折、计算机断层扫描(CT)结果以及格拉斯哥预后量表评估的预后进行分析。通过t检验比较差异以确定显著性。当将意识水平与入院时的血清NSE水平进行比较时,意识出现三位数代码障碍的患者的NSE水平显著高于其他患者(p<0.005)。当根据改良荒木分类分析NSE时,有局灶性体征的延长型患者的NSE水平高于其他任何类型(与短暂型相比,p<0.001)。有颅骨骨折的患者的NSE水平显著高于无颅骨骨折的患者(p<0.01)。CT扫描显示有挫伤的患者的NSE水平显著高于无挫伤的患者(p<0.005)。(摘要截选至250字)