张燕松;花琳琳;郝潇;林粤婷;薛孟周;

• 1:郑州大学第二附属医院
• 2:郑州大学脑出血疾病先进医学研究中心河南省脑出血脑损伤国际联合实验室

摘要(Abstract)：

目的探讨血清淀粉样蛋白A(serum amyloid A, SAA)联合神经元特异性烯醇化酶(neuron-specific enolase,NSE)对诊断脑出血的临床价值。方法选取2018-03—2020-03郑州大学第二附属医院80例脑出血患者为观察组,其中轻度组40例,重度组40例;另外选取同期40例健康体检者为对照组。应用ROC曲线对血清淀粉样蛋白A联合NSE检测对脑出血的诊断价值进行分析。结果重度组血清中SAA、NSE水平均高于轻度组和对照组(P<0.05);联合检测的灵敏度、特异度高于SAA或NSE单独检测。结论 SAA联合NSE对脑出血患者的早期诊断、临床干预具有重要意义。

关键词(KeyWords)： 脑出血;血清淀粉样蛋白A;神经元特异性烯醇化酶;ROC曲线

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金面上项目（编号：82071331,81870942）;国家自然科学基金重点国际（地区）合作研究项目（编号：81520108011）;; 国家重点研发计划项目（编号：2018YFC1312200）

作者(Authors): 张燕松;花琳琳;郝潇;林粤婷;薛孟周;

参考文献(References)：

• [1]TATLISUMAK T,CUCCHIARA B,KURODA S,et al.Nontraumatic intracerebral haemorrhage in young adults[J].Nat Rev Neurol,2018,14(4):237-250.DOI:10.1038/nrneurol.2018.17.
• [2]WILKINSON D A,PANDEY A S,THOMPSON B G,et al.Injury mechanisms in acute intracerebral hemorrhage[J].Neuropharmacology,2018,134(Pt B):240-248.DOI:10.1016/j.neuropharm.2017.09.033.
• [3]HOSTETTLER I C,SEIFFGE D J,WERRING D J.Intracerebral hemorrhage:an update on diagnosis and treatment[J].Expert Rev Neurother,2019,19(7):679-694.DOI:10.1080/14737175.2019.1623671.
• [4]WALSH K B,CAMPOS B,HART K,et al.M2 Monocyte Microparticles Are Increased in Intracerebral Hemorrhage[J].J Stroke Cerebrovasc Dis,2017,26 (10):2369-2375.DOI:10.1016/j.jstrokecerebrovasdis.2017.05.027.
• [5]ABOUELASRAR SALAMA S,GOUWY M,VANDAMME J,et al.The turning away of serum amyloid Abiological activities and receptor usage[J].Immunology,2020 Dec 14.DOI:10.1111/imm.13295.
• [6]DE BUCK M,GOUWY M,WANG J M,et al.The cytokine-serum amyloid A-chemokine network[J].Cytokine Growth Factor Rev,2016,30:55-69.DOI:10.1016/j.cytogfr.2015.12.010.
• [7]HUANGFU X Q,WANG L G,LE Z D,et al.Utility of serum amyloid A as a potential prognostic biomarker of acute primary basal ganglia hemorrhage[J].Clin Chim Acta,2020,505:43-48.DOI:10.1016/j.cca.2020.02.022.
• [8]KIMURA F,KADOHAMA T,KITAHARA H,et al.Serum Neuron-Specific Enolase Level as Predictor of Neurologic Outcome after Aortic Surgery[J].Thorac Cardiovasc Surg,2020,68(4):282-290.DOI:10.1055/s-0038-1677511.
• [9]XUE M,YONG V W.Neuroinflammation in intracerebral haemorrhage:immunotherapies with potential for translation[J].Lancet Neurol,2020,19(12):1023-1032.DOI:10.1016/s1474-4422(20)30364-1.
• [10]GARTON T,HUA Y,XIANG J,et al.Challenges for intraventricular hemorrhage research and emerging therapeutic targets[J].Expert Opin Ther Targets,2017,21(12):1111-1122.DOI:10.1080/14728222.2017.1397628.
• [11]REN H,HAN R,CHEN X,et al.Potential therapeutic targets for intracerebral hemorrhage-associated inflammation:An update[J].J Cereb Blood Flow Metab,2020,40(9):1752-1768.DOI:10.1177/0271678X20923551.
• [12]DUAN X,WEN Z,SHEN H,et al.Intracerebral Hemorrhage,Oxidative Stress,and Antioxidant Therapy[J].Oxid Med Cell Longev,2016,2016:1203285.DOI:10.1155/2016/1203285.
• [13]GUSDON A M,NYQUIST P A,TORRES-LOPEZ V M,et al.Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy[J].Stroke,2020,51(1):129-136.DOI:10.1161/strokeaha.119.027085.
• [14]IRONSIDE N,CHEN C J,DING D,et al.Perihematomal Edema After Spontaneous Intracerebral Hemorrhage[J].Stroke,2019,50(6):1626-1633.DOI:10.1161/STROKEAHA.119.024965.
• [15]PENG W J,LI Q,TANG J H,et al.The risk factors and prognosis of delayed perihematomal edema in patients with spontaneous intracerebral hemorrhage[J].CNSNeurosci Ther,2019,25(10):1189-1194.DOI:10.1111/cns.13219.
• [16]BAI Q,XUE M,YONG V W.Microglia and macrophage phenotypes in intracerebral haemorrhage injury:therapeutic opportunities[J].Brain,2020,143(5):1297-1314.DOI:10.1093/brain/awz393.
• [17]ZHU H,WANG Z,YU J,et al.Role and mechanisms of cytokines in the secondary brain injury after intracerebral hemorrhage[J].Prog Neurobiol,2019,178:101610.DOI:10.1016/j.pneurobio.2019.03.003.
• [18]GURSKY O.Structural Basis for Vital Function and Malfunction of Serum Amyloid A:an Acute-Phase Protein that Wears Hydrophobicity on Its Sleeve[J].Curr Atheroscler Rep,2020,22(11):69.DOI:10.1007/s11883-020-00888-y.
• [19]SHRIDAS P,DE BEER M C,WEBB N R.High-density lipoprotein inhibits serum amyloid A-mediated reactive oxygen species generation and NLRP3 inflammasome activation[J].J Biol Chem,2018,293(34):13257-13269.DOI:10.1074/jbc.RA118.002428.
• [20]WICKER E,BENTON L,GEORGE K,et al.Serum Amyloid A Protein as a Potential Biomarker for Severity and Acute Outcome in Traumatic Brain Injury[J].Biomed Res Int,2019,2019:5967816.DOI:10.1155/2019/5967816.
• [21]黄晋，吴汶芳，禚娅.血清SAA与β2-MG水平对急性脑梗死患者预后的预测价值[J].中国实用神经疾病杂志，2020,23(20):1773-1779.DOI:10.12083/SYSJ.2020.21.006.
• [22]YU J,ZHU H,TAHERI S,et al.Serum Amyloid A-Mediated Inflammasome Activation of Microglial Cells in Cerebral Ischemia[J].J Neurosci,2019,39(47):9465-9476.DOI:10.1523/JNEUROSCI.0801-19.2019.
• [23]DICHEV V,KAZAKOVA M,SARAFIAN V.YKL-40and neuron-specific enolase in neurodegeneration and neuroinflammation[J].Rev Neurosci,2020,31(5):539-553.DOI:10.1515/revneuro-2019-0100.
• [24]XU C M,LUO Y L,LI S,et al.Multifunctional neuron-specific enolase:its role in lung diseases[J].Biosci Rep,2019,39(11):10.1042/BSR20192732.
• [25]LIU Q,FAN J,XU A,et al.Distribution of serum neuron-specific enolase and the establishment of a population reference interval in healthy adults[J].J Clin Lab Anal,2019,33(5):e22863.DOI:10.1002/jcla.22863.
• [26]MAURO C,PASSERINI R,SPAGGIARI L,et al.New and old biomarkers in the differential diagnosis of lung cancer:Pro-gastrin-releasing peptide in comparison with neuron-specific enolase,carcinoembryonic antigen,and CYFRA 21-1[J].Int J Biol Markers,2019,34(2):163-167.DOI:10.1177/1724600819834235.
• [27]ELSHORBAGY H H,BARSEEM N F,ELSADEK AE,et al.Serum Neuron-specific Enolase and S100 Calcium-binding Protein B in Pediatric Diabetic Ketoacidosis[J].2019,11(4):374-387.DOI:10.4274/jcrpe.galenos.2019.2018.0280.
• [28]ERTL M,WEBER S,HAMMEL G,et al.Transorbital Sonography for Early Prognostication of Hypoxic-Ischemic Encephalopathy After Cardiac Arrest[J].J Neuroimaging,2018,28(5):542-548.DOI:10.1111/jon.12528.
• [29]GONEN M,OZDOGAN S,BALGETIR F,et al.S100Band neuron-specific enolase levels in episodic and chronic migraine[J].Acta Neurol Scand,2021,143(3):298-302.DOI:10.1111/ane.13365.
• [30]SIMANI L,SADEGHI M,RYAN F,et al.Elevated Blood-Based Brain Biomarker Levels in Patients with Epileptic Seizures:A Systematic Review and Meta-analysis[J].ACS Chem Neurosci,2020,11 (24):4048-4059.DOI:10.1021/acschemneuro.0c00492.
• [31]MOZAFARI J,MOTAMED H,MASOUMI K,et al.Characteristics of S100B and Neuron Specific Enolase in Differentiating Acute Vertigo Cases with Central Cause;a Diagnostic Accuracy Study[J].Archives of Academic Emergency Medicine,2020,8(1):e3.
• [32]LU W,JIANG C,WANG Z,et al.Lactic acid,neuron-specific enolase,and blood-brain barrier index after a severe traumatic brain injury:a prospective study[J].Br J Neurosurg,2020:1-5.DOI:10.1080/02688697.2020.1823938.
• [33]SLAVOACA D,BIRLE C,STAN A,et al.Prediction of Neurocognitive Outcome after Moderate-Severe Traumatic Brain Injury Using Serum Neuron-Specific Enolase and S100 biomarkers[J].J Med Life,2020,13(3):306-313.DOI:10.25122/jml-2020-0147.