急性颅脑损伤血清S100B蛋白浓度变化及临床意义

Changes of Protein Concentration of Serum S100B and Its Clinical Significance in Acute Brain Injury

目的探讨急性颅脑损伤患者血清中S100B蛋白水平的动态变化及临床意义。方法选取2009年10月至2012年9月成都市龙泉驿区第一人民医院收治的急性颅脑损伤患者60例为研究对象(颅脑损伤组),选择同期健康体检者50例作为健康对照组,采用酶联免疫吸附测定法测定两组受试者血清S100B蛋白水平变化。结果颅脑损伤组在损伤后24 h内及第2、6、12日的S100B水平均高于健康对照组(P<0.05)。颅脑损伤轻、中、重型组中患者血清S100B水平在损伤24 h内及第2、6、12日的变化差异有统计学意义(P<0.05),颅脑损伤程度越重,血清S100B水平越高。颅脑损伤轻、中、重型预后良好率分别为84.2%、73.1%、40.0%,差异有统计学意义(P<0.05)。格拉斯哥预后评分与S100B蛋白水平呈显著负相关(r=-0.465,P<0.05)。结论血清S100B蛋白水平可反映急性颅脑损伤的严重程度,具有较高的敏感性、特异性和准确性,可作为早期判断颅脑损伤程度和预后的血清标志物,为颅脑损伤的临床诊断和治疗提供参考。

Objective To explore the dynamic changes and clinical significance of protein level of serum S100B in patients with acute brain injury. Methods Sixty cases with acute brain injury admitted to the First People＇s Hospitai of Longquanyi District in Chengdu City from October 2009 to September 2012 were selected as the research objects. 50 cases who underwent physical examination in the same period were selected as the control group. SI00B protein＂ level was measured in serum by enzyme-linked immunosorbent assay. Results S100B level of acute brain injury within 24 hours and at 2^nd ,6th , 12＇h day of the injury was higher than that of the control group（ P 〈 0.05 ）. The changes of serum SI00B levels within 24 hours and at 2＇＇l , 6th , 12th day of the injury in the light,medium and severe acute brain injury group were statistically signifi- cant （ P 〈 O. 05 ） , and the more severe the brain injury, the higher the level of serum SIOOB. The goad rate of prognosis in light, medium and heavy brain injury was 84.2% ,73.1% ,40.0% respectively, the difference was statistically significant（ P 〈 0.05 ）. GOS and S100B protein level had significant negative correlation （ r = - 0. 465, P 〈 O. 05 ）. Conclusion Serum S100B protein levels could reflect the severity of acute brain injury. With high sensitivity, specificity, and accuracy, serum SIOOB protein can be used as early serum markers to determine the degree of head injury and the prognosis, and provide a reference for clinical diagnosis and treatment of traumatic brain injury.