Neuron-Specific Enolaza as a Marker of Lesion Cerebral Tissue in Patients with Ischemic Stroke

25% within first 60% of patients are profound disabilities, and only n ‘ ABSTRACT Objective: A promising area in modern angioneurology is the study of markers of brain tissue damage in the serum of patients in the acute period of ischemic stroke and their comparison with the initial level of neurological deficit and the consequences of stroke. The functions of neuron-specific enolase (NSE) are actively studied as a marker of brain tissue damage. The aim is to investigate the level of NSE in the acute period of ischemic stroke. Material and Methods: The clinical study included 151 patients (mean age 61.5 ± 8.2 years) who divided into 2 groups: the 1 st group consisted of 85 patients with acute ischemic stroke; Group 2 - 66 patients with chronic cerebral ischemia. Plasma HCV levels were determined in all patients. Analyzed the correlation NSE with the severity of neurological deficit NIHSS , functional S ac and c u a scale Bartel, level of disability on a scale Rankine severity of cognitive impairment on MMSE. The relationship between NSE levels and survival of patients with ischemic stroke was determined. Results: In patients of the 1st group, the level of NCE exceeded the rate of patients in the 2 nd group by 3.8 times (p <0.001). Significant differences in the level of NCE depending on the location of the focus of ischemia - in the basin of the left middle cerebral artery and vertebrobasilar basin (p = 0.04). In paragraph atsiyentiv with severe neurological deficit exceeded the level of NSE index patients with medium and light neurological deficit at 1,3 (p = 0,251) and 2,3 (p = 0,007) times respectively. A correlation was established between the level of NCE and the severity of neurological deficit (r = 0.67, p = 0.027), which indicates a direct relationship between the degree of ischemic injury and neurological disorders. In patients with severe cognitive impairment, the level of HCE exceeded that of patients with moderate and mild cognitive impairment by 1.2 (p = 0.444) and 1.9 (p = 0.037) times, respectively. When assessing the relationship between the level of NCE with the consequences of stroke, a tendency to higher n indicators of NCE in the dead (p = 0, 083). The limit value of the level of NSE in the blood of patients with ischemic stroke was determined - 40 ng/ ml. Conclusion: Determination of HCE in blood plasma confirms the degree of neuronal damage and is an informative indicator of the presence of neurological deficits in patients with acute ischemic stroke. Results: The results indicate a potential role for the determination of NCE content in improving the stratification of the risk of death in patients with ischemic stroke.

Fifth of returning to work [2][3][4][5].With the development of laboratory diagnostics actively in yvchayutsyapathophysiological and marker and prognosis tion stroke, but according to the literature has a low diagnostic kg innist many parameters [6][7][8][9]. In recent decades, great attention and chapel yayetsya indicator of brain damage -neuronspecific first enolaz and (NSE) [10,11]. Along with this, there is little data on the value of NCE in cerebrovascular diseases.The study of the level of NCE was carried out in various pathologies. Plasma NSA concentrations increase in stroke, Alzheimer's disease, epilepsy, traumatic brain injury, and multiple sclerosis. If the damage neurons NSE enters the blood through the blood-brain bar ' Jer.
In the acute period of stroke there is an immune adjustment, in particular, antibodies to NSE are produced [12].There is an assumption that the level of NSE can correlate and with the severity of brain damage and , thus , the clinical status of patients. However, data on this issue remain contradictory in the literature. Thus, a study by Pandey A, et al. found an increase in NCE in patients with stroke compared with the control group. Index NSE correlated and the level of glucose in patients with hyperglycemia was associated with worse stroke [13]. There was a higher level of NCE in deceased patients. In other studies [14], these changes did not depend on the presence or absence of diabetes. Some authors consider a NSE and independent markers of prognosis of acute ischemic stroke.
In other studies, low levels of NSE associated with less about ' in volume infarct [15]. At the same time,Jung CS, et al. [16], having studied the markers of brain damage in the serum of patients with subarachnoid hemorrhage and secondary ischemic brain damage as a result of cerebral vasospasm, concluded that NCE does not correlate with either vasospasm or cerebral ischemia.
Alatas ÖD, et al. [17] identified in patients with netravmatych their internal rishnomozkovymy bleeding you soup biomarker concentrations compared to the control group, but the correlation with NSE about ' in volume hemorrhage in is not found.Dementia is in OV and sang. Based on previous results last captured or conclude that the NSE level makes it impossible to predict the volume of cerebral ischemic foci after systemic thrombolysis [18].
In the study of NSE in liquor on average 8.5 hours after the onset of clinical symptoms of R Brouns, et al. detects and L and differences NSE levels between patients with stroke and control groups [19].
According to the results of other studies, the level of NCE rarely exceeded the norm [20]. At the same time there is evidence that the average level of NSE in serum of patients with ischemic stroke significantly HI th (p <0,001), than in the control group [21].
In other Shih studies NSE index was not associated with stroke etiology of the system TOAST, and not correlated with NIHSS indicator of onset of the disease and about ' in volume of ischemic foci [19].I studied the prognostic value of NSE in patients with stroke. There was an increase in the level of NSE in ischemic stroke in patients with severe motor deficiency, regardless of age, which allowed us to consider this marker as an independent predictor of the consequences of ischemic stroke.At the same time, the NSE index remained stable or decreased until discharge from hospital (compared at with the original index) in patients younger and older, are discharged with clinical improvement [22]. In the works of some authors marked and significant correlation with NSE Rankin scale and that allowed to discuss potential prognostic NSE.
Performed at Xia studies to assess functional outcome of 30-day stroke using a modified Rankine scale (mRS) [23].
In idznacheno the level of NSE in the 1 st day of illness was significantly correlated with the level of mRS at 30 days (r = 0,744, p <0.001), the average concentration of NSE in patients with mRS≥3 (worst result) was significantly HI th compared with patients with mRS<3 (best result) (p <0,001). Similar results were obtained in other studies [24] that assessed functional neurological deficits by NIHSS: found a significant correlation between HCE and N IHSS levels on day 60 (r = 0.461, p = 0.001).The level of NSE korelyuva in (p <0,001) with the level of disability in called ' connection with a significant increase in blood at the blood-brain damaged bar ' EMU [21].Thus, there is currently no detailed information on the importance of NSE in cerebrovascular disease. P Rothe, because NSE is neyron-specific marker , it can be used ground to Define spare the degree of ischemic damage to the brain. The addition of scientific data on the influence of molecular pathogenetic factors on the course of the acute period of stroke was the subject of our study.
The aim of the study was to investigate the level of neuronspecific enolase in the acute period of ischemic stroke. All patients performed neuropsychological examination using for orotk first scales and assessment of mental status (MMSE) [25].The level of NCE in all patients was determined by enzymelinked immunosorbent assay. In interpreting the results, the data of Hoffinian la Roche on the limits of normal values were taken into account . From these materials it follows that in 95% of serum samples from healthy people, the NCE values are below 15 ng / ml [26]. Blood for analysis of the level of NSE was taken on the day of   When assessing the relationship between the level of NCE with the consequences of stroke (patients who survived and patients who died) revealed a tendency to higher NCE in patients who died, but this relationship did not reach the degree of reliability ( p = 0, 083 ). In patients who died level of NSE was 57, 7 ± 10, 5 ng / ml in patients who have you lived -34 , 8  Thus, NSE has a high diagnostic value in the acute period of ischemic stroke and allows not only to assess the degree of brain tissue damage, but also allows to predict the course and possible consequences of ischemic stroke in the long term.