Serum Neuron-Specific Enolase Level as Predictor of Neurologic Outcome after Aortic Surgery
別タイトル
大血管手術後における神経学的予後予測因子としての血清神経特異的エノラ－ゼ値
著者
木村, 文昭
(Kimura, Fumiaki)
上位タイトル
Thoracic and Cardiovascular Surgeon
(2019.
1)
識別番号
DOI
10.1055/s-0038-1677511
その他
PMID：30669174
博士論文情報
学位授与番号
10107A530
学位授与年月日
2019-3-25
学位名
博士（医学）
学位授与機関
旭川医科大学
抄録
BACKGROUND:
This study aimed to evaluate the significance of serum neuron-specific enolase (NSE) level as a predictor of neurologic injury in thoracic aortic surgery.
METHODS:
We neurologically assessed 60 consecutive patients who underwent thoracic aortic surgery for thoracic aortic aneurysm (n = 26) and aortic dissection (n = 34). Using moderate hypothermic circulatory arrest with antegrade cerebral perfusion, total arch replacement and hemiarch replacement were performed in 37 and 23 patients, respectively. Serum NSE levels in venous blood samples drawn before surgery and at 1 day after surgery were measured. Severity of neurologic injury was categorized as either uncomplicated (n = 48), temporary neurologic dysfunction (TND, n = 5), or permanent neurologic dysfunction (PND, n = 7). The extent of stroke was estimated on computed tomography or magnetic resonance imaging.
RESULTS:
The NSE level significantly differed among the three groups (PND > TND > uncomplicated) on the first postoperative day. Receiver-operating characteristic curve analysis showed that the cutoff value of NSE level was 34.14 ng/mL for neurologic injury (sensitivity, 0.769; specificity, 0.851) and 43.56 ng/mL for PND (sensitivity, 1.000; specificity, 0.963). The NSE level significantly correlated with the extent of stroke (r = 0.61, p < 0.001).
CONCLUSION:
Serum NSE level is a significant predictor of adverse neurologic outcomes and extent of stroke after thoracic aortic surgery.
