Нейрон-специфическая энолаза как возможный показатель нейронального повреждения при острых менингитах у детей

Acute meningitis in children is a common cause of complications and leads to developmental disabilities. That is the reason why it is important to look for possible markers that indicate nerve tissue damage for early diagnosis, their prevention and prognosis of CNS complications. Objective. To examine Neuron Specific Enolase (NSE) and its diagnostic significance as an indicator of neuronal damage in children with acute meningitis. Materials and methods. Blood samples of 40 children with acute meningitis and 30 of healthy children between the ages of 1 month to 18 years old were studied. The measurement of NSE was made from a blood serum during the first 24 hours after hospitalization by the enzyme-linked immunosorbent assay test performing. The degree of impaired consciousness was determined by the Glasgow Coma Scale. The results were processed with the Student’s t-test, correlation and regression analysis methods with constructing confidence intervals. Results. NSE levels in children with acute meningitis was 7.6 times higher than the results of healthy children, which was 22.56 ± 1.14 and 2.95 ± 0.16 ng/ml, respectively, (P < 0.0001) (95 % CI; 19.19 to 20.03). CNS complications of the disease in patients were detected in 22 (55 %). Patients with complications had significantly higher level of NSE than patients without complications and it was 25.35 ± 1.61 and 18.60 ± 1.49 ng/ml, respectively, (P < 0.01) (95 % CI; 5.74 to 7.75). Impaired consciousness was observed in 21 (52.5 %) patients. The content of NSE in patients with impaired consciousness was within 20.72 ± 7.33 ng/ml and it was higher than NSE content in patients with normal consciousness that was within 16.56 ± 4.69 ng/ml (P < 0.05) (95 % CI; 0.17 to 8.14). Reliable inverse and strong correlation was detected between the NSE level and the level of consciousness by the Glasgow Coma Scale, where the coefficient of determination R 2 = 0.624 and coefficient of correlation r -0.785 (P < 0.001) (95 % CI; -1.08 to -0.48). Conclusions. Thus, the data indicates that acute meningitis occurs with the brain matter damage. The blood NSE content in acute meningitis can be used as a biochemical marker for the neuronal damage severity and as a prognostic marker for the CNS complications development.