中枢神经系统疾患与S-100β蛋白的关系

Relationship between central nervous system diseases and S-100 beta protein

目的:回顾中枢神经系统疾患时S-100β蛋白在脑组织、血液和脑脊液中的变化情况,并试图找到与疾病的早期评估、病情严重程度及预后的关系。资料来源:利用计算机检索Medline1996-01/2005-01有关中枢神经系统疾患时S-100β蛋白表达变化情况的文献,检索词“S-100β”,限定语言类型为English。同时检索中文期刊全文数据库1996-01/2005-01的文献,检索词为“S-100β”,限定语言类型为中文。资料选择:浏览文题和摘要,选择与中枢神经系统疾患发生、发展及实验评估有关的文献,查找典型文献的原文阅读。资料提炼:检索到的关于脑缺血、创伤性脑损伤、缺血缺氧性脑病、中枢神经系统炎症和癫痫S-100β蛋白的表达与作用的文献共65篇,选择观点相似的文献引用28篇。资料综合:①脑缺血后的早期S-100β在脑脊液和血液中即有显著意义的升高,并且同梗死体积、临床状态和功能预后具有相关性。②血清S-100β可作为判断缺氧缺血性脑病病情程度的客观依据和早期诊断缺氧缺血性脑病以及预后评估的主要指标。③血清S-100β可作为急性全脑缺血(心脏停搏)后24h患者预后可靠的标志物。④创伤性脑损伤后S-100β血清水平的升高同损伤的严重程度和神经放射学发现均有相关性,并为创伤性脑损伤预后不良的指标。⑤S-100β水平在其他中枢神经系统疾患如炎症、胶质细胞瘤和癫痫等也有不同程度的变化。结论:血清和脑脊液中S-100β水平同中枢神经系统疾患的发生、发展和临床状态关系密切,有望成为评估中枢神经系统疾患临床状态及预后的实验室指标。

OBJECTIVE： To review the changes of S-100 beta protein （S-100β） in brain tissue, blood and cerebrospinal fluid in patients undergoing central nervous system diseases, and try to find the relationship of the biochemical marker with early diagnosis, severity and prognosis of these central nervous system diseases DATA SOURCES： A computer-based online search of Medline database was undertaken to identify articles about the expression changes and role of S-100β after eentral nervous system diseases from January 1996 to January 2005 in English by using the keyword of ＂S-100β protein＂. Meanwhile, Chinese articles were searched in China National Knowledge Infrastructure （CNKI） published from January 1996＂to January 2005 with the same keyword. STUDY SELECTION： The titles and abstracts were browsed, articles about the occurrence, evolution and experimental evaluation of central nervous system diseases were selected, and the original articles of being representative were found and read thoroughly. DATA EXTRACTION： There were 65 literatures about the expression and role of S-100β after cerebral ischemia, ischemia and anoxia encephalopathy, traumatic brain injury, central nervous system inflammation and epilepsy, and 28 with the representative viewpoints were cited. DATA SYNTHESIS： ①Even in the early time of cerebral ischemia, there was marked elevation of S-100β protein level in cerebrospinal fluid and blood, and it had close correlations with the infarction volume, clinical status and functional prognosis. ② Serum level of S-100β may be a main marker for evaluating the severity and prognosis of ischemia and anoxia encephalopathy. ③ Serum level of S-100β may be a reliable marker for the prognosis at 24 hours after acute whole brain ischemia （cardiac arrest）.④ Serum S-100β protein level had close correlation with the severity and radiological findings after traumatic injury, and might be an index for poor prognosis. ⑤There were also changes to some degree for S-100β protein level after central nervous system diseases such as inflammation, gliocytoma and epilepsy.