SERUM NEURON-SPECIFIC ENOLASE IN PATIENTS DURING THE ACUTE PERIOD OF ISCHEMIC STROKE WITH CONCOMITANT OBSTRUCTIVE SLEEP APNEA SYNDROME
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i1.14458Keywords:
Neuron-specific enolase, ischemic stroke, obstructive sleep apnea syndrome, CPAP-therapy, respiratory supportAbstract
SUMMARY. The work is devoted to the study of the dynamics of changes in the marker of ischemia of neurons – neuron-specific enolase (NSE), in patients during the acute period of ischemic stroke and the concomitant obstructive sleep apnea syndrome (OSAS).
The aim – to study the dynamics of NSE changes in patients during the acute period of ischemic stroke with concomitant OSAS against the background of non-invasive respiratory support.
Material and Methods. There were observed 60 patients with a verified ischemic stroke (1–13 points according to NIHSS), who were performed somnological examinations during the first day of the stroke and OSAS was detected, which required respiratory correction. Patients were divided into two groups. Group I patients, who for various reasons refused to use respiratory support, continued to be treated according to the clinical protocol. For the patients of group II, the basic treatment was supplemented with the respiratory support. The level of NSE was determined by the immunoenzymatic method during the first day of hospitalization and after 7 and 14 days of treatment. Statistical analysis was performed using the licensed program STATISTICA 12 (StatSoft Inc., USA). The significance level of differences was p<0.05.
Results. The initial values of the median NSE level in patients of the groups I and II were 31.17 [28.54–38.41] ng/ml and 32.65 [28.71–43.65] ng/ml, respectively. After 7 days of treatment, the NSE level decreased at 15.2 % in patients of the group I, and at 22.7 % (p<0.001) during the 14th day to the level of 24.09 [22.36–28.48] ng/ml, compared to the initial values. In patients of the group II, the level of NSE decreased at 40.4 % (p<0.001) already during the 7th day of therapy, and during the 14th day at 56.3 % (p<0.001) to the level of 14.28 [12.49–16.22] ng/ml, compared with the original values.
Conclusions. Serum NSE – is a highly sensitive index of the severity of ischemic brain damage, which can be used to evaluate the effectiveness of various treatment strategies in patients with the ischemic stroke. Supplementation of the basic complex with non-invasive respiratory support (auto CPAP-therapy) ensured a decrease in the level of serum NSE at 40.4 % during the 7th day and at 56.3 % (p<0.001) during the 14th day of observation to the limit of 14.28 ng/ml.
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