血清S100β和肌钙蛋白Ⅰ与动脉瘤性蛛网膜下腔出血患者临床预后的关联性

Association of serum S100β and troponin Ⅰwith clinical outcomes in aneurysmal subarachnoid hemorrhage patients

目的分析动脉瘤性蛛网膜下腔出血(a SAH)患者血清S100β和肌钙蛋白I水平与其临床预后的关联性。方法前瞻性选择2013年1月至2015年12月收治的a SAH患者50例作为研究组,同时选择50例健康成人作为对照组。主要观察指标为两组研究对象血清S100β和肌钙蛋白I水平。同时根据出院时改良Rankin量表(mRS)将a SAH患者分为预后不良组(mRS评分≥3)和预后良好组(mRS评分≤2),采用ELISA法检测血清S100β水平,采用全自动免疫分析仪检测血清肌钙蛋白I水平。比较研究组与对照组及研究组中预后不良组与预后良好组患者的血清S100β、肌钙蛋白I水平,分析二者在a SAH的诊断及预后预测中的价值。结果与对照组比,研究组患者S100β水平[(1.59±0.40)μg/L vs(0.40±0.11)μg/L,P=0.000]和肌钙蛋白I水平显著升高[(0.61±0.16)μg/L vs(0.14±0.04)μg/L,P=0.000]。与预后良好组相比,预后不良组患者S100β水平显著升高[(1.77±0.36)μg/L vs(1.42±0.36)μg/L,P=0.001];肌钙蛋白I水平差异则无统计学意义[(0.63±0.14)μg/L vs(0.59±0.17)μg/L,P=0.342]。S100β在诊断患者预后不良中ROC曲线下面积为0.758(95%CI:0.625~0.891,P=0.002);肌钙蛋白I在诊断患者预后不良中曲线下面积为0.596(95%CI:0.434~0.758,P=0.244)。结论血清S100β在预测a SAH患者的临床预后中具有良好的应用价值。

Objective To investigate the association of serum S100β and troponin I with clinical outcomes in patients with aneurysmal subaraehnoid hemorrhage （aSAH）. Methods Fifty patients with aSAH received and cured from January 2013 to December 2015 were prospectively collected （reseach group） ,and 50 healthy adults were selected as control group. According to modified Rankin Scale （mRS） score at the time of discharged from hospital, the patients in reseach group were re-divided into poor prognosis group（ mRS score 33 ） and good prognosis group （mRS score ≤2）. Enzyme linked immunosorbent assay （ELISA）method was used to detect level of serum S100β. Automatic immune analyzer was used to detect level of serum troponin I. The levels of serum S100β and troponin I were compared between research group and contol group,as well as between poor prognosis group and good prognosis group. The values of serum S100β and truponin I for the diagnosis of aSAH and for the prediction of clinical outcome were analyzed. Results Levels of serum S100β and troponin I in reseach group significantly increased compared with those in control group [ （ 1.59 ± 0.40 ） μg/L vs （0. 40 ± 0.11 ） μg/L,P =0.000;（0.61±0.16） μg/L vs （0.14 ±0.04） μg/L,P=0. 000]. Compared with good prognosis group,level of serum S10013 in poor prognosis group significantly increased [ （ 1.77 ± 0. 36 ）μg/L vs （ 1.42 ±0. 36 ） μg/L, P = 0.001 ] , but troponin I level showed no significant difference between two groups[ （0.63 ±0.14） μg/L vs 0. 59 ±0.17 μg/L,P = 0. 342 ]. The area under a receiver operating characteristic crave （ROC） of S100β for the diagnosis of poor prognosis was 0. 758 （ 95 % CI：0. 625 - 0. 891, P = 0. 002 ） , while the area under ROC of troponin I for the diagnosis of poor prognosis was 0. 596（95% CI：0. 434- 0. 758,P = 0. 244）, and this indicated that 100β had higher accuracy for the diagnosis of poor prognosis in patients with aneurysmal subarachnoid hemorrhage. Conclusion Serum S100β has a good cinical value for predicting clinical outcomes in patients with aneurysmal subaraehnoid hemorrhage.