Neuron-specific Enolase As An Aid To Diagnosis And Outcome Prediction In Patients With Head Injury

Objective: Head Injuries are common disease in nuerosurgery. There are no laboratory index to judge the trauma degree and outcome prediction after head injury until now. Neuron-specific enolase (NSE) , will release from the neurons and neuroendocrine cells when they are damaged. NES could be a kind of sensitive marker in head injury patients because it should be high level in serum and CSF. The research is to explore the effect of NSE to head trauma through testing NES level both in serum and CSF, and to aid the diagnosis and outcome prediction. Methods: Sixty-five patients with acute head injury and 60 normal people were included in the study. The patients were divided into three groups (minor, moderate, and severe) according to Glasgow coma scales (GCS). The patients were divided into there group (death, poor recovery, good recovery).according to Glasgow Outcome Scales (GOS).The serum and CSF sample would be collected at one, three, and seven days after head injury. NSE in serum and in CSF in each group were tested by enzyme-immunity. The outcome were done one month after trauma for every patients with Glasgow outcome score (GOS).Results:The Concentration of NSE in each groups(minor, moderate and sever )were higher than normal controls. The NSE peak values of serum NSE andCSF-NSE were reached in 24 hour after injury (p<0.01), then the concentration were gradually decreases in the following three days and sever days. The level of serum NSE and CSF-NSE were the highest in severe group, and moderate group were higher then minor groups. The concentration of serum NSE and CSF-NSE were the highest in death groups. And poor recovery were higher than good recovery groups .Concentration of serum NSE and CSF-NSE in patient groups were higher than normal controls. The concentration change of serum NSE and CSF-NSE were positive correlation in the one days, three days and seven days after head injury, respectively.(r=0.309,P<0.05;r=0.479, P<0.01;r=0.636,P<0.01). Conclusion: The serum and CSF-NSE could be as a laboratory marker for head injury patients. The method is simple, specific and sensitive. These results support the use of serum NSE and CSF-NSE estimation of the degree of brain injury and prognosis of patients with head injury. The NSE test in serum alone could be indictable in clinical application.