血清S-100B蛋白与碱性髓鞘蛋白评估重型脑外伤预后的对比研究

Contrast analysis of S-100B and myelin basic protein in outcome prediction in patients with severe head injury

目的 探讨重型脑外伤患者血清S-100B蛋白和碱性髓鞘蛋白（MBP）浓度在预后评估中的价值。方法 2006年1月-12月重型脑外伤患者40例,患者均于外伤后12 h内抽取血清,分别应用单克隆双位点放免法和酶联免疫检测分析测定血清S-100B蛋白和MBP浓度,以同期随机选取的15名健康体检者作为正常对照,并结合格拉斯哥预后评分进行分析。设定分界值和绘制ROC曲线,比较S-100B蛋白与MBP评估预后的敏感性和特异性。结果 重型脑外伤患者伤后血清S-100B蛋白和MBP浓度均显著高于正常对照组;重型脑外伤不同预后组之间S-100B蛋白和MBP浓度存在显著差异。评估预后的特异度和敏感度在S-100B蛋白分别为91%和72%,MBP分别为63%和61%;ROC曲线显示,S-100B蛋白对预后评估的敏感性和特异性较MBP更强。结论 伤后血清S-100B蛋白浓度对评估重型脑外伤预后具有较高的特异性和敏感性,因此可作为临床上评估重型脑外伤预后的一种可靠方法。

Objective To investigate the role of S-100B and myelin basic protein （MBP） in outcome prediction in patients with severe head injury. Methods From January 2006 to December 2006, 40 patients with severe head injury were involved into this study. Serum samples of each patient were obtained within 12 hours after head injury, and serum concentrations of S-100B and MBP were measured. Fifteen healthy controls were randomly selected and analysis was conducted with Glasgow outcome scale. The cut point was set and receiver operating characteristic curves were obtained. The sensitivity and specificity of S-100B and MBP in outcome prediction were compared. Results The serum concentrations of S-100B and MBP in patients with severe head injury were significantly higher than those of the healthy controls. There were significant differences in concentrations of S-100B and MBP between groups of different outcomes. The specifieity and sensitivity of S-100B in outcome prediction were 91% and 72% , respectively, and those of MBP were 63% and 61% , respectively. It was revealed by ROC curves that S-100B had more favourable specificity and sensitivity in outcome prediction than MBP did. Conclusion Serum S-100B has higher specificity and sensitivity in outcome prediction in patients with severe head injury, and may serve as a reliable parameter for clinical application.