血清S100蛋白含量与颅脑损伤严重程度及预后的关系

Relationship between content of serum S100 protein and severity and prognosis of craniocerebral injury

目的探讨血清中S100蛋白含量与颅脑损伤严重程度及预后的关系。方法选择2012年6月~2013年9月在我院神经外科住院治疗的颅脑损伤患者,按患者入院时格拉斯哥昏迷量表（GCS）评分分为重型（3~8分）、中型（9~12分）、轻型（13~15分）,各30例。所有患者入院后立即采血检测S100蛋白并行GCS评分,之后每第1、3、7、14天抽血检测S100蛋白,记录每次GCS计分,随访6个月,预后判断按照GCS结果分为预后良好组（包括轻中残）,预后不良组（包括重残和植物生存）,死亡组。随机抽取30名健康成人血作为对照组：均为同期来本院健康体检者。采用电化学发光法测定S100蛋白,观察比较检测结果。结果颅脑损伤组血清中S100蛋白含量较正常对照组高,差异有统计学意义（P〈0.01）;重伤组血清中S100蛋白含量高于轻、中伤组,差异有统计学意义（P〈0.01）;预后不良组血清S100蛋白含量较预后良好组高,差异有统计学意义（P〈0.05）。结论颅脑损伤后血清S100蛋白含量变化与影像学改变、伤情、预后密切相关。血清中S100蛋白检测方法方便、快捷,可成为临床上判断神经系统损伤程度和预后的生化指标。

Objective To explore the relationship between content of serum S100 protein and severity and prognosis of craniocerebral injury. Methods Patients with brain injury from June 2013 to September 2012 in our hospital depart-ment of neurosurgery were selected,and were divided into types of severe （3 to 8 points）,moderate （9 to 12 points）,and mild（13 to 15 points）,according to Glasgow coma scale （GCS） on admission,with 30 cases in each group.The S100 pro-tein was tested by blood collection and GCS was scored once patients were admitted into our hospital.After that, S100 protein was tested in 1st, 3rd, 7th,and 14th days, and GCS score was recorded each time.After 6-months follow up visits, based on outcomes of GCS,prognosis was divided into good prognosis group（mild and moderate disability）,poor prognosis group （severe disability and vegetative survival）,and death group.Meanwhile,during the same period,blood from 30 healthy people was randomly collected and categorized into control group.S100 protein was measured by electrochemi-luminescence. Results Serum S100 protein content in the craniocerebral injury group was greatly increased compared with that of normal control group,with a statistical difference （P〈0.01）.Serum S100 protein content in severe type group was higher than mild and moderate groups respectively,with statistical difference（P〈0.01）.Content of serum S100 protein in poor prognosis group was obviously increased in comparison with that of good prognosis group,with a statistical dif-ference （P〈0.05）. Conclusion Changes of serum S100 protein after craniocerebral injury is closely related with imageo-logical change,traumatic condition,and prognosis.S100 protein assay method is convenient and quick in serum,which can be considered as a biochemical indicator evaluating injury degree of nervous system and prognosis.