S100β蛋白对不同类型眩晕的诊断价值

Diagnostic value of S100β protein in different types of vertigo

目的:评价S100β蛋白、基质金属蛋白酶-9(MMP-9)、可溶性血管细胞间黏附分子-1(s VCAM-1)和胶质纤维酸性蛋白(GFAP)对不同类型眩晕的诊断价值。方法:选择2013年6月至2016年12月,在我院就诊的后循环梗死、非血管性眩晕患者各29例和19例,同时入选体检人群20例作为对照,比较S100β、MMP-9、s VCAM-1和GFAP在不同组间的差异,同时评价各指标对后循环梗死的诊断价值。结果:S100β不同组间比较,差异有统计学意义(F=5.503,P<0.05),其中后循环梗死组高于非血管性眩晕和对照组(t=4.038、5.582,P=0.014、0.008),MMP-9和s VCAM-1组间比较,差异无统计学意义(F=1.598、1.662,P>0.05),GFAP仅9例患者超过检测下限;S100β、MMP-9和s VCAM-1的诊断ROC曲线下面积(AUC)分别为0.720、0.570、0.518(Z=4.806、1.046、2.523,P=0.023、0.414、0.609),敏感度为84.21%、66.73%、53.84%,特异性为57.50%、47.74%、30.58%,S100β诊断折点为0.049μg/L。结论:S100β对区分后循环梗死和非血管源性眩晕有较高的临床价值。

Objective： To evaluate the S100β protein,matrix metalloproteinase-9（ MMP-9）,soluble vascular cell adhesion molecule-1（ s VCAM-1） and glial fibrillary acidic protein（ GFAP） in diagnosis of different types of vertigo. Methods： From June 2013 to December 2016,29 cases and 19 cases posterior circulation infarction and non-vascular vertigo patients were selected in our hospital. 20 subjects were selected as control group. The difference of S100β,MMP-9,s VCAM-1,and GFAP in the different groups were compared and the diagnostic value of each index for posterior circulation infarction were evaluated. Results： There were significant differences between different groups of S100β（ F = 5. 503,P〈 0. 05） and posterior circulation infarction group was higher than non-vascular vertigo and control group（ t = 4. 038,5. 582,P = 0. 014,0. 008）. There was no significant difference between groups of MMP-9 and s VCAM-1（ F = 1. 598,1. 662,P〈 0. 05 GFAP）,only 9 patients reached the detection limit. AUC of ROC curve in S100β,MMP-9 and s VCAM-1＇s were 0. 720,0. 570,0. 518（ Z = 4. 806,1. 046,2. 523,P = 0. 023,0. 414,0. 609）,the sensitivity was 84. 21%,66. 73%,53. 84%,57. 50%,47. 74%,the specificity was 30. 58%. Break point for diagnosis in S100β was0. 049μg/L. Conclusion： S100β has high clinical value in differentiating posterior circulation infarction from non-vascular vertigo.