S100B评估弥漫性轴索损伤及其预后的临床研究

Clinical Study on S100B Protein Assessment of Diffuse Axonal Injury and Its Prognosis

目的分析弥漫性轴索损伤(DAI)患者S100B蛋白水平与病情变化和患者预后的关系。方法严格按照经典的弥漫性轴索损临床诊断标准,选择确诊为DAI的患者30例为观察组,并选择同期10例排除颅脑疾病的健康体检者为对照组,检测两组患者不同时间点血浆S100B蛋白含量,随访6个月,用简易智能量表(MMSE)及Glasgow预后评分(GOS)评价患者预后。结果观察组各时间点间血浆S100B含量差异有统计学意义(P<0.01),患者血浆S100B蛋白含量在伤后12 h内迅速上升,24 h达高峰,然后逐渐下降;DAI患者GOS评分和MMSE评分与血浆S100B蛋白含量呈明显负相关(r=-0.852、-0.831,P<0.01)。结论 S100B蛋白与DAI关系密切,颅脑损伤越严重,血浆S100B蛋白含量越高,预后越差。

Objective To analyze the relationship between S100B protein levels and changes of disease condition as well as prognosis in patients with diffuse axonal injury（DAI）.Methods In strict accordance with conventional diagnostic criteria for DAI,30 patients were selected as the observation group,while 10 healthy people without cerebral disease were selected as the control group.The plasma S100B protein content in two groups of patients was determined at different time points.Following up within 6 months,their prognosis were evaluated with mini mental state examination（MMSE） and Glasgow outcome scale（GOS）.Results At all time points plasma S100B concentration differences of the observation group were statistically significant（P〈0.01）.Plasma S100B protein content rose rapidly after injury within 12 h,reaching a peak at 24 h and then decreased gradually.The MMSE scores and GOS scores of DAI patients were inversely correlated with their plasma S100B protein contents（r=-0.852,-0.831,P〈0.01）.Conclusion S100B protein is closely related with DAI.The more serious the brain injury,the higher the plasma S100B protein level and the worse the prognosis.