저산소뇌증 환자에서 혈청 Neuron-Specific Enolase 수치와 예후

Abstract

Background: Hypoxic brain damage is a critical situation and needs emergent treatment. Even with a successful treatment of the underlying causative disease, the extent of injury to brain parenchyma is often severe and irreversible. Clinical outcome of hypoxic brain damage is determined by the degree of diffuse brain damage. Although neuroimaing and electrophysiological study help to predict the clinical outcome, it is often difficult to perform these test because of unstable vital sign and technical problem. Therefore, reliable and feasible methods for early prediction of prognosis need to be established. Methods: This study included 22 patients with hypoxic brain damage after resuscitation. Serum Neuron-Specific Enolase (NSE) level within 24 hours after resuscitation was measured by enzyme immunoassay. Clinical outcome was assessed by the use of Glasgow Outcome Scale (GOS) at 6 months after onset. Results: In 22 patients, 18 (81.8%) patients had poor outcome, and 4 (19.2%) patients showed favorable recovery. A serum NSE concentration above 20 ng/mL was found to be a predictor of poor outcome with a high positive predictive value (93.8%). Concentrations more than 22 ng/mL predicted poor outcome with a high specificity (100%) and a positive predictive value of 100%. Conclusion: In patients with hypoxic brain damage, serum NSE concentrations of >22 ng/mL was predictive of poor clinical outcome with a high specificity. We suggest that serum NSE may be a feasible and valuable biochemical marker for prediction of clinical outcome in hypoxic brain damage