癫痫持续状态患儿血清神经元特异性烯醇酶和脑SPECT改变的意义

Serum neuron specific enolase and SPECT rCBF imageing in childhood status epilepticus

摘要:

目的   探讨血清神经元特异性烯醇酶（ＮＳＥ）和单光子发射计算机断层仪（ＳＰＥＣＴ）脑血流显像改变在癫痫持续状态（ＳＥ）患儿中的价值。方法   用ＥＬＩＳＡ法检测ＳＥ患儿入院后第１，３，７天外周血ＮＳＥ浓度，用同位素９９ｍＴｃ标记，ＥＣＤ显像剂药盒进行脑血流显像。结果  ＳＥ患儿血清ＮＳＥ浓度第１天为（１５．１３± ６．２２）μｇ／Ｌ，较正常对照[（２．６４± ０．７７）μｇ／Ｌ］明显增高（Ｐ＜ ０．０１）；第３，７天逐渐下降，至第７天基本达正常水平[（４３５±１６５）μｇ／Ｌ］。１５例行ＳＰＥＣＴ脑血流显像者，异常率为７３．４％。结论  ＳＥ患儿存在脑损伤，血清ＮＳＥ检测对诊断脑损伤有重要价值，动态检测可帮助判断预后。ＳＰＥＣＴ脑血流显像对脑部病灶部位判断意义较大，而判断脑损伤仅有辅助价值。

Abstract:

OBJECTIVE: To evaluate the diagnostic va lue of serum neuron specific enolase(NSE) and single photo emission computed tomography(SPECT) regional cerebral blood flow(rCBF) imaging in childhood status epilepticus(SE). METHODS: Serum NSE concentration was assayed in 28 children with SE and in 40 normal controls using E LISA. SPECT rCBF imaging was performed in 15 cases of SE. RESULTS: The mean serum NSE concentration in the SE patients [(15.13± 6.22) μg/L] was higher than that in normal cont rols [(2.64± 0.77) μg/L] on day 1(P < 0.01). However,it gradually reduced from day 3 and normalized on da y 7. SPECT rCBF imaging was abnormal in 11 of the 15 SE cases.CONCLUSIONS: Serum NSE is a marker in the diagnosis of brain injury in children with SE. SPECT rCBF imaging may be useful in assessing the location of brain injury in children with SE.