S-100B蛋白与NSE评估重型脑外伤预后的临床研究

The predictive value of S-100B and NSE in outcome of patients with severe head injury

目的研究重型脑外伤后血清S-100B蛋白、神经特异性烯醇化酶(NSE)浓度在预后评估中的价值。方法对40例重型脑外伤住院病人在伤后12 h内进行血清S-100B、NSE浓度检测,并结合GCS评分进行比较分析。结果本组病人伤后血清S-100B、NSE浓度均显著性高于正常对照组,不同预后组之间S-100B、NSE浓度存在显著性差异。以伤后12 h血清S-100B浓度2.0μg/L、NSE浓度30ng/ml为分界标准评估预后,S-100B评估预后的特异度为91%,敏感度72%;NSE特异度为77%,敏感度67%。ROC曲线(受试者工作特性曲线)显示S-100B对预后的评估较NSE更敏感、更特异。结论伤后血清S-100B蛋白、NSE浓度对评估预后具有较高的特异性和敏感性。而S-100B浓度在预后评估中的作用较NSE更为敏感、特异,因此可作为一种评估重型脑外伤预后的可靠临床方法。

Objective To elucidate the role of S-100B and NSE in predicting the prognosis of patients with severe head injury. Methods The serum concentrations of S-100B and NSE within 12 hours after injury were measured in 40 patients with severe head injury, and compared with the outcomes of all patients evaluated by GCS. Results The serum concentrations of S-100B and NSE in severe head injury group were higher than the normal control group, and were significantly different between good and poor outcome groups. The sensitivity and specificity of the evaluation of the serum S-100B level of 2.0 μg/L 12 hours after the injury are 91% and 72%, and which are 77% and 67% of the NSE of 30 ng/ml. The predictive role of S-100B to the outcome was more sensitive than NSE according to the ROC curves. Conclusion The findings suggest that the serum concentrations of S-100B and NSE within 12 hours after injury may have predictive values in prognosis of patients with severe head injury, and the serum concentration of S-100B may be a more promising outcome predictor.