Correale J, Rabinowicz A L, Heck C N, Smith T D, Loskota W J, DeGiorgio C M
Department of Neurology, LAC/USC Medical Center, USC School of Medicine, Los Angeles, CA, USA.
Neurology. 1998 May;50(5):1388-91. doi: 10.1212/wnl.50.5.1388.
Neuron-specific enolase (NSE) is a sensitive marker of brain damage in stroke, global ischemia, and coma. Serum NSE is also correlated with the duration and outcome of status epilepticus (SE). CSF-NSE levels have not been previously reported in SE. We report the CSF concentrations of NSE in 11 patients with cryptogenic/remote symptomatic SE. CSF obtained within 24 hours of SE showed increased concentrations of NSE in 9 of 11 patients. The mean CSF-NSE for the group was elevated compared with the levels for normal control subjects (30.8 +/- 18.33 versus 10.76 +/- 3.08 ng/mL; p = 0.002). Further, CSF-NSE levels were elevated compared with simultaneous serum levels in the same group of patients (p = 0.01). In addition, the CSF/serum albumin ratio (QAlb), a measure of the integrity of the blood-brain barrier, was increased in SE patients compared with control individuals (33.4 versus 4.79 x 10(-3); p = 0.0001). An increase of QAlb correlated with CSF-NSE (rs = 0.66, p = 0.04) and serum NSE levels (rs = 0.83, p = 0.004). CSF-NSE is a promising in vivo marker for brain injury after SE.
神经元特异性烯醇化酶（NSE）是中风、全脑缺血和昏迷中脑损伤的敏感标志物。血清NSE也与癫痫持续状态（SE）的持续时间和预后相关。此前尚未有关于SE患者脑脊液NSE水平的报道。我们报告了11例隐源性/远期症状性SE患者的脑脊液NSE浓度。在SE发作24小时内采集的脑脊液显示，11例患者中有9例NSE浓度升高。该组患者的脑脊液NSE平均水平高于正常对照受试者（30.8±18.33对10.76±3.08 ng/mL；p = 0.002）。此外，同一组患者的脑脊液NSE水平高于同期血清水平（p = 0.01）。另外，作为血脑屏障完整性指标的脑脊液/血清白蛋白比值（QAlb）在SE患者中高于对照个体（33.4对4.79×10⁻³；p = 0.0001）。QAlb升高与脑脊液NSE（rs = 0.66，p = 0.04）和血清NSE水平（rs = 0.83，p = 0.004）相关。脑脊液NSE是SE后脑损伤有前景的体内标志物。
