Abstract：
Neuron-specific-enolase is used as a marker of neurological prognosis after cardiopulmonary resuscitation. It is also present in red blood cells and platelets. It is not known whether hemolysis increases the values of neuron-specific-enolase enough to clinically affect its interpretation in critically ill patients who are to be introduced to veno-arterial extracorporeal oxygenation. In this study, we examined the relationships among neuron-specific-enolase and hemolysis indicators such as free hemoglobin and lactate dehydrogenase after the introduction of veno-arterial extracorporeal oxygenation. Of the 91 patients who underwent veno-arterial extracorporeal membrane oxygenation in our hospital from January 1, 2018, to February 24, 2021, 68 patients survived for more than 24 h. Of these, 14 patients who were categorized into the better cerebral performance categories (1-3) and 19 patients who were categorized into the poor neurological prognosis category (4) were included. After the introduction of veno-arterial extracorporeal membrane oxygenation, neuron-specific-enolase was markedly higher in the poor neurological prognosis group than in the good neurological prognosis group (41.6 vs. 92.0, p = 0.04). A significant positive correlation was revealed between neuron-specific-enolase and free hemoglobin in the good neurological prognosis group (rs = 0.643, p = 0.0131). A similar relationship was observed for lactate dehydrogenase and neuron-specific-enolase in both the conscious (rs = 0.737, p = 0.00263) and non-conscious groups (rs = 0.544, p = 0.0176). When neuron-specific-enolase is used as a marker for neuroprognostic evaluation, an abnormally high value is likely to indicate the lack of consciousness, whereas a lower elevation should be interpreted with caution, taking into account the effects of hemolysis.
摘要：
神经元特异性烯醇化酶被用作心肺复苏后神经系统预后的标志物。它也存在于红细胞和血小板中。目前尚不清楚溶血是否会增加神经元特异性烯醇化酶的值，足以在临床上影响其对重症患者的解释，这些患者将被引入静脉动脉体外氧合。在这项研究中,我们研究了引入静脉动脉体外氧合后神经元特异性烯醇化酶与溶血指标如游离血红蛋白和乳酸脱氢酶之间的关系.2018年1月1日至2021年2月24日在我院行静脉-动脉体外膜氧合的91例患者中，有68例患者存活时间超过24h。包括14名被归类为较好的脑表现类别（1-3）的患者和19名被归类为较差的神经预后类别（4）的患者。在引入静脉动脉体外膜氧合之后，神经预后不良组的神经元特异性烯醇化酶明显高于神经预后良好组（41.6vs.92.0，p=0.04）。神经预后良好组神经元特异性烯醇化酶与游离血红蛋白呈正相关(rs=0.643,p=0.0131)。在有意识组（rs=0.737，p=0.00263）和无意识组（rs=0.544，p=0.0176）中，乳酸脱氢酶和神经元特异性烯醇化酶的关系相似。当神经元特异性烯醇化酶被用作神经预后评估的标志物时，异常高的值可能表明缺乏意识，而较低的海拔应谨慎解释，考虑到溶血的影响。
