亚低温治疗重型颅脑损伤患者的血清S—100B蛋白含量分析

Detection of serum S-100B protein in patients with severe head injury receiving mild hypothermia treatment

目的通过检测亚低温治疗后重型颅脑损伤患者血清S-100B蛋白含量的变化来证实亚低温治疗的脑保护作用，探讨其可能的作用机制。方法选取100例正常体检者为对照组，选取100例重型颅脑损伤患者（GCS≤8分）并分为亚低温治疗组50例和常温治疗组50例．分别于伤后早期（2～6h）及伤后不同时间（1d、3d、5d、7d、10d）采血，检测血清中S-100B蛋白含量，比较其在伤后不同时期的血清S-100B蛋白含量。结果正常体检者血清S-100B蛋白含量测定结果证实，正常人血清S-100B蛋白含量与年龄、性别无关。亚低温治疗组、常温治疗组患者伤后血清S-100B蛋白含量与对照组相比差异有统计学意义（P〈0．01）。伤后1d、3d、5d、7d、10d时亚低温治疗组血清S-100B含量明显低于常温治疗组，差异有统计学意义（P〈0．05）。结论血清S-100B蛋白在重型颅脑损伤的诊断中有高度敏感性和特异性，是一种有效的生化指标。亚低温治疗对重型颅脑损伤具有脑保护作用。

Objective To evaluate the effect of mild hypothermia for brain protection by detecting the changes in serum S-100B protein in patients with severe head injury and investigate the possible mechanism. Methods With 100 healthy volunteers as the control group, 100 patients with severe head injury （Glascow Coma Score ≤ 8） received treatment with mild hypothermia （n=50） or normothermia （n=50）. Serum samples were collected from the patients early （2-6 h） after the injury and at 1, 3, 5, 7, and 10 days after the injury to measure the levels of S-100B protein. Results In healthy subjects, the serum level of S-100B protein was not associated with age or gender. Patients with severe head injury receiving mild hypothermia treatment and normothermia treatment showed significant differences in serum S-100B protein level from the control group （P〈0.01）. The patinets with mild hypothermia treatment had significantly lower serum S-100B level than those treated with normothermia at 1, 3, 5, 7, and 10 days after the injury （P〈0.05）. Conclusion Serum S-100B protein has high sensitivity and specificity in the diagnosis of severe head injury, and may serve as an effective biochemical indicator. Mild hypothermia may protect the brain tissue of patients with severe head injury.