颅脑损伤患者血清S-100B蛋白浓度的动态变化及其临床意义

Dynamic change and clinical significance of plasma S-100B protein following brain injuries

目的通过对血清S-100B蛋白浓度的动态检测,探讨其在颅脑损伤严重程度分型及预后评估中的意义。方法对120例颅脑损伤患者按照格拉斯哥评分(GCS评分)分为轻型、中型、重型3组,用酶联免疫吸附法动态检测伤后6h内及伤后第2～6天患者血清S-100B蛋白浓度,结合临床表现及伤后2周格拉斯哥预后评分(GOS评分)进行比较分析。结果颅脑损伤组患者血清S-100B蛋白浓度明显高于正常对照组(P<0.05);轻型、中型、重型颅脑损伤组患者之间血清S-100B蛋白浓度存在显著性差异(P<0.05);颅脑损伤早期(6小时内)血清S-100B蛋白浓度显著升高,轻型颅脑损伤组多在1～2内下降,中型颅脑损伤组多在2～3内下降,重型颅脑损伤组持续保持较高水平;预后良好组与预后恶劣组之间血清S-100B蛋白浓度存在显著性差异(P<0.05)。结论血清S-100B蛋白浓度是判断颅脑损伤严重程度及预后的一种客观生物学指标。

Objective Through serial measure of plasma S-100B protein following brain injury, to explore it＇s clinical significance in the grading of brain injury and prognosis evaluation. Methods A total of 120 patients with brain injury were divided into minor grade, moderate grade and severe grade according to the Glascow seore. Serum S-100B protein were serially measured with ELISA in 6h after injury and daily thereafter for 2-6 days in order to analyse with clinical symptom and Glasgow Coma Scale. Results The concentrations of S-100B protein in serum of brain injuries were significantly higher than those of normal group （P 〈0.05）; The concentrations of S-100B protein in serum of minor grade, moderate grade and severe grade were different （P 〈0.05）; The concentrations of S-100B protein in serum were significantly elevated in 6h after brain injury, and were descended in 1-2 days in minor grade and were descended in 2-3 days in moderate grade, but were continuously elevated in severe group; The concentrations of S-100B protein in serum in the group with poor prognosis were higher than that in the group with favourable prognosis. Conclusion The concentration of S-100B protein in serum may be an objective biomarker for the evaluation of severeity and prognosis of brain injury.