Correlation Between Serum Ferritin Level And Neuron Specific Enolase And Spontaneous Intracerebral Hemorrhage

ObjectivesWe undertook the study to investigate the correlation between the dynamic change of serum ferritin level and neuron specific enolase (NSE) and the prognosis in patients with intracerebral hemorrhage (ICH); to evaluate the relationship between serum ferritin level and NSE and coefficient of relative brain edema volume.Methods1. According to the selection criteria,40patients were enrolled into intracelebral hemorrhage (ICH) group and40healthy individuals into control group.2. At one month after onset of symptoms, patients in ICH group were evaluated by modified Rankin Score (mRS) and divided into two subgroups:good outcome group with mRS≤2and poor outcome group with mRS>2.3. In ICH group, patients were assessed by age,sex, temperature, blood pressure, and scale by National Institute of Health Stroke Score (NIHSS) at admission (see Table1); and mRS scores at one month after the onset of symptoms (see Table2).4. In ICH group, laboratory data were tested including (1) complete blood counts, serum glucose, D dimer, and C-reactive protein (CRP) on admission;(2) serum ferritin level and NSE on day1,5, and14respectively after onset of symptoms.(3) head Computerized Tomography (CT) scan on day land5respectively after onset of symptoms.5. In control group, serum ferritin level and NSE were measured once. Results1. Serum ferritin level was increased by a various degree after ICH and appeared dynamic change:there was no statistically significant difference (P>0.05) between day5(295.27±120.78ng/ml) and day14(250.07±129.53ng/ml); both day5and14were higher that day1(162.98±70.10ng/ml)(P<0.05).2. Serum NSE was elevated by a various degree after ICH and appeared dynamic change:day5(14.20±6.39ng/ml) was higher than day1(10.22±3.21ng/ml) and day14(10.68±3.14ng/ml)(P<0.05); there was no statistically significant difference (P>0.05) between day1and14.3. On day1, there was a positive correlation between serum ferritin level and NSE; however, there was no significant correlation between both serum ferritin level and NSE and relative brain edema volume coefficient.4. On day5, there was a positive correlation between serum ferritin level and NSE; there was also a positive correlation between serum ferritin level and coefficient of relative brain edema volume; and a positive correlation between NSE and coefficient of relative brain edema volume.5. On day5and day14as well, the higher the serum ferritin and NSE were, the poorer the outcome was; in addition, elevated variables, including D dimer, white cell counts, CRP, temperature, NIHSS score on admission, and bleeding volume, indicated poor outcome.Conclusions1. Compared to control group, both serum ferritin level and NSE were higher in ICH group and showed dynamic change; and also had significant difference in good and poor outcome groups on day5and day14, respectively. Therefore, serum ferritin level and NSE are indicators of assessing ICH severity and evaluating prognosis. 2. There was a positive correlation on day5between serum ferritin, NSE and coefficient of relative brain edema volume. In addition, the peak values of serum ferritin level and NSE were found on day5, which were in accordance with the peak presentation of brain edema, and therefore can provide clues on evaluation and treatment of brain edema after ICH.