摘要
目的探讨急性创伤性颅脑损伤（TBI）患者血浆S100B蛋白动态变化水平及临床意义。方法选择就诊的急性TBI患者58例,收集其入院时即刻、伤后24 h、72 h及168 h外周静脉血标本,同时选取50例健康成年人为健康对照组并收集其外周静脉血标本,采用酶联免疫吸附双抗体夹心法（ELISA）检测以上108例研究对象的外周血血浆S100B蛋白水平,并在颅脑外伤发生后6个月时,根据患者GOS得分将急性TBI患者分为预后良好的A组（31例）及预后不良的B组（27例）,比较3组血浆S100B蛋白动态变化水平。结果 A组血浆S100B蛋白在颅脑损伤后24 h达到高峰,72~168 h开始下降至正常水平;B组在入院后予积极治疗后血浆S100B蛋白可有所下降,但随病情进展,可再次升高。B组各个时间点均高于A组（P〈0.05）及健康对照组（P〈0.01）,A组患者血浆S100B蛋白水平伤后即时、伤后24 h、72 h较健康对照组高（P〈0.05）,伤后168 h时与同时间点的健康对照组比较差异无统计学意义（P〉0.05）。Spearman相关分析结果显示,血浆S100B蛋白与GOS评分的相关系数r=-0.672。预测预后方面,伤后即时检测血浆S100B蛋白水平较GCS评分价值更高（P〈0.05）。伤后168 h检测血浆S100B蛋白水平对评估预后价值最高（AUC=0.937）,灵敏度为94.20%,特异度为85.63%。结论血浆S100B蛋白与颅脑损伤患者预后关系密切,其在血浆中的水平在预测患者预后有重要临床意义。
Objective To investigate the dynamic changes and clinical significance of plasma levels of S100 B protein in patients with acute traumatic brain injury（ TBI）. Methods Fifty-eighty patients with acute TBI treated in emergency department of our hospital from September 2012 to August 2014 were enrolled in the study. The peripheral vein blood specimens of 58 patients（ observation group） and 50 healthy subjects（ control group） were collected immediately after injury,24 h,72h and 168 h after injury. The plasma levels of S100 B protein were detected by double antibody sandwich enzyme-linked immunosorbent assay（ ELISA）. Moreover the 58 patients in observation group were redivided into two groups according to GOS score at 6 months after TBI,and 31 patients with better prognosis were divided into group A,however,the othet 27 patients with poorer prognosis were divided into group A. The dynamic changes of plasma levels of S100 B protein were compared between group A and group B. Results The plasma levels of S100 B protein in group A reached peak at the first 24 hours,then which reduced to normal levels in the next 72 ~ 168 hours,however,the plasma levels of S100 B protein in group B were decreased at some extent by active treatment after hospitalization,but with the progress of pathogenetic condition,which increased again. The plasma levels of S100 B protein in group B in every time point were significantly higher than those in group A（ P〈0. 05） and control group（ P〈0. 01）. The plasma levels of S100 B protein in group A at injury instant,24 h,72h after TBI were significantly higher than those in control group（ P〈0. 05）,but there were no significant differences at 7d after TBI between group A and control group（ P〈0. 05）. Spearman correlation analysis showed the correlation coefficient between plasma levels of S100 B protein and GOS score was 0. 672. The detection of plasma levels of A100 B immediately after TBI had more important value in predicting prognosis,as compared with GCS score（ AUC 0. 856 vs 0. 669,P〈0. 05）. The detection of plasma levels of S100 B protein at 168 h after TBI had the most important value in predicting patient＇s prognosis（ AUC = 0. 937）,with sensitivity being 94. 20% and specificity being 85. 63%. Conclusion The plasma levels of S100 B protein in patients with TBI are closely correlated to patient＇s prognosis,thus the detection of plasma levels of S100 B protein has an important clinical significance in predicting patient＇s prognosis.
出处
《河北医药》
CAS
2015年第21期3209-3211,共3页
Hebei Medical Journal
关键词
颅脑损伤
S100B蛋白
预后
craniocerebral trauma
S100B protein
prognosis
