Clinical Value Of Neuron Specific Enolase In Patients With Vascular Dementia Caused By Ischemic Stroke

Background and Purpose Vascular dementia(VD)is a syndrome of intellectual impairment caused by cerebral nerve dysfunction caused by various cerebrovascular diseases(CVD).It is one of the common types of senile dementia.The causes of the disease are complex,and the clinical manifestations are diverse,which will significantly reduce the quality of life of elderly patients in their later years.Therefore,we must strive to find and diagnose the disease as early as possible,This will undoubtedly be of great significance to the occurrence and development of VD.A special enzyme,Neuron specific enolase(NSE),is distributed in neuroendocrine and neuron cells.When cells or tissues of the patient’s brain are damaged,the nerve structure distributive elements become necrotic and disintegrate,and NSE enters the gap between cerebrospinal fluid and biological cells.This enzyme has the ability to penetrate the blood-brain barrier into human blood,Therefore,it is a significant indicator in evaluating the severity of nerve cell injury.Previous studies have shown that the existence of NSE is closely related to the occurrence and development of severe diseases such as ischemic stroke.Moreover,the greater the NSE expression level tested by professional application technology,the more serious the level of brain damage.Therefore,it is sometimes used clinically as an important marker to detect whether there is ischemic stroke [1].However,there are few studies on whether NSE can be used as a marker of VD caused by ischemic stroke.Therefore,the purpose of this study is to explore the application value of neuron specific enolase in the diagnosis of VD by studying the level of neuron specific enolase in patients with VD caused by ischemic stroke.Methods A total of 100 patients with acute ischemic stroke hospitalized in the Department of Neurology of the First Hospital of Qiqihar from January 2018 to December 2018 were selected and divided into VD(+)group(vascular dementia group)and VD(-.The diagnosis and treatment of VD met the diagnostic criteria of VD in the Diagnostic and Statistical Manual of Mental Disorders,the 5th edition of the American Psychiatric Association.The patients with medical pain in the VD(+)and VD(-)groups were scored by the National Institute of Health Stroke Scale(NIHSS)and classified by TOAST,and the general epidemic infectious disease reference data of all patients with medical pain in the two groups,as well as relevant risk influencing factor data information were collected to compare the differences of basic reference data between the two groups.Fasting venous blood was collected within 24 hours after the admission of patients with medical pain to detect the content of NSE in their serum.The patients with acute ischemic stroke were recorded as stroke group,and the expression of NSE was compared with that of healthy control group.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of serum NSE in VD caused by ischemic stroke.At the same time,the mini mental state examination(MMSE)was used to assist the diagnosis and severity grading of dementia in VD patients.The VD(+)group was divided into mild,moderate and severe dementia groups,and the expression of NSE in serum of each group was compared.The eighth edition of Neurology introduced a variety of VD classifications,mainly including: infarct dementia in key areas,multiple infarct dementia(cortical vascular dementia),watershed infarct dementia(hypoperfusion dementia),hemorrhagic dementia,arteriosclerotic encephalopathy,and autosomal dominant hereditary cerebral artery disease accompanied by white matter encephalopathy and subcortical infarction.NSE expression among different types was compared.Results1.Compared with the healthy control group,the content of serum NSE in the stroke group was significantly higher(p < 0.001).The NSE value was 20.07 ± 6.37 μG/L in the VD(+)group,and 8.94 ± 3.28 μG/L in the VD(-)group.It was significantly higher in the VD(+)group than the VD(-)group(p < 0.05).2.ROC results showed that the area under the curve of serum NSE concentration in the diagnosis of VD caused by ischemic stroke was 0.955,the sensitivity was 90%,and the specificity was 88%.3.In the comparison of serum NSE content among the mild,the NSE value was15.24 ± 3.50g/L in the mild dementia group,21.30 ± 5.13 μ g/L in the moderate dementia group and 29.19 ± 5.85 μ g/L in the severe dementia group.There was significant difference among the three groups(p< 0.05).The NSE value of the severe dementia group was higher than that of the moderate dementia group and the mild dementia group(p< 0.05).There was no significant correlation between the type of dementia and the expression of serum NSE(p > 0.05).Conclusions1.The expression of NSE in serum of the VD patients caused by ischemic stroke was significantly increased.The high expression of NSE in serum may be closely related to the occurrence of VD.2.Serum NSE may be used as a biological index for the diagnosis of VD caused by ischemic stroke.3.The content of serum NSE in patients with VD caused by ischemic stroke may be positively correlated with the severity of VD,but maybe not correlated with the type of VD.