S100β蛋白和脑电图在危重症患儿脑功能监测中的价值

The value of S100β protein and electroencephalogram in cerebral function monitoring of critically ill children

目的探讨S100β蛋白和脑电图监测在危重病例患儿脑功能监测中的价值。方法根据小儿危重病例评分将2014年9月至2016年12月收治入我科患儿分为危重组（评分≤80分）30例和非危重组（评分〉80分）30例。在收治我科后24 h、72 h、1周3个时间点分别收集患儿血清标本并动态监测患儿脑电图。收集标本使用ELISA方法检测S100β蛋白量。结果危重组男22例，女8例；年龄（3.68±1.37）岁。非危重组男21例，女9例；年龄（2.52±0.86）岁。两组患儿的性别比例和年龄比较，差异无统计学意义（P〉0.05）。危重组患儿入院时Glasgow评分为（8.67±1.83）分，明显低于非危重组（13.05±2.94）分，差异有统计学意义（P〈0.05）。入院后24 h、72 h、1周3个时间点危重组患儿血清S100β蛋白量为（112.55±29.20）μg/L、（120.86±17.10）μg/L、（279.82±28.80）μg/L，明显高于非危重组（0.51±0.06）μg/L、（0.32±0.03）μg/L、（0.34±0.05）μg/L（P〈0.05）；但组内3个时间点血清S100β蛋白水平比较差异均无统计学意义（P〉0.05）。24 h、72 h、1周3个时间点危重组患儿脑电图检查异常率[19例（63.3%）、18例（60.0%）、20例（66.7%）]明显高于非危重组[9例（30%）、7例（23.3%）、6例（20.0%）]（P〈0.05）。结论S100β蛋白和动态脑电图监测有助于早期发现危重症患儿脑损伤情况，有助于临床病情评估，在危重患儿脑功能监测中有重要价值。

Objective To investigate the value of S100β protein and electroencephalogram （EEG） in cerebral function monitoring of critically ill children. Methods Sixty critically ill children admitted in our department from September 2014 to December 2016, were divided into 2 groups according to pediatric critical illness score （PCIS） ,30 cases in critical group （PCIS ≤80 scores） and 30 cases of non critical group （PCIS 〉80 scores）. Serum samples were collected from the 60 cases at 24 h,72 h and 1 week after admission, respectively. The serum S100β protein and EEG were dynamically monitored on 3 time points. ELISA was used to test the content of S100β protein of collected samples. Results There was no statistically significant difference in gender and age between critical group and non critical group[male/female ：22/8 vs. 21/9;age： （3.68 ± 1.37） years vs. （2. 52±0. 86）years,P 〉0. 05]. The glasgow score of critical group was lower than that of non critical group （8.67 ± 1.83 vs. 13.05 ± 2. 94, P 〈 0.05 ）. Serum S100β protein contents of critical group were （ 112. 55 ± 29. 20 ） μg/L, （ 120. 86 ± 17.10） μg/L, and （ 279. 82 ± 28.80 ） μg/L） at 24 h, 72 h and 1 week respectively, which were obviously higher than those of non cricical group[ （0. 51 ± 0.06） μg/L, （0. 32 ±0. 03） μg/L, （0. 34 ±0. 05） μg/L] （P 〈0. 05）. Meanwhile,the abnormal rate of EEG monitoring of critical group were 19 cases （ 63.3% ）, 18 cases （60. 0% ）, 20 cases （ 66. 7% ） at 24 hours, 72 hours and 1 week respectively,which were also obviously higher than those of non critical group E9 cases （30. 0% ）, 7 cases（23.3% ） ,6 cases（20. 0% ） ] （ P 〈 0. 05 ）. Conclusion Both serum S10013 protein and dynamically EEG monitoring contribute to detect the status of cerebral injury in early stage, with significant value in cerebral funcdon monitoring of critically ill children.