S100β、IL-1β与IL-6联合检测对青壮年颅脑损伤诊断及预后评估的价值

VALUE OF COMBINED MEASUREMENT OF S100β, INTERLEUKIN-1β, AND INTERLEUKIN-6 IN DIAGNOSIS AND PROGNOSTIC EVALUATION OF YOUNG ADULTS WITH TRAUMATIC BRAIN INJURY

目的探讨血清和脑脊液中S100蛋白质β(S100β)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)联合检测对青壮年创伤性颅脑损伤(TBI)诊断和预后评估的价值。方法选取青岛市市立医院神经外科术后转入ICU治疗的青壮年TBI病人132例作为观察组(轻型35例,中型55例,重型42例),以同期需行脑脊液穿刺检查的非TBI住院青壮年病人50例作为对照组。采用电化学发光法检测两组病人血清和脑脊液中S100β、IL-1β、IL-6的含量。应用受试者工作特征曲线(ROC曲线)分析S100β、IL-1β、IL-6联合检测对TBI的诊断价值,分析血清S100β、IL-1β、IL-6水平与TBI病人预后的相关性。结果观察组重型病人血清和脑脊液中S100β、IL-1β、IL-6含量均显著高于对照组(F=8.351~8.967,P<0.05)。观察组血清中S100β、IL-1β、IL-6的含量与脑脊液中的含量均呈正相关关系(r=0.83~0.89,P<0.05)。血清S100β、IL-1β、IL-6检测及三者联合检测诊断TBI的ROC曲线下面积分别为0.810、0.758、0.703和0.922。观察组血清和脑脊液中S100β、IL-1β、IL-6的表达水平与青壮年TBI预后呈负相关关系(F=8.671~9.371,P<0.05)。结论血清和脑脊液中S100β、IL-1β、IL-6水平与青壮年TBI病人病情严重程度和预后密切相关,且三者联合检测诊断效率高于单独检测。

Objective To investigate the value of combined measurement of S100β, interleukin-1β(IL-1β), and interleukin-6 (IL-6) in serum and cerebrospinal fluid in the diagnosis and prognostic evaluation of young adults with traumatic brain injury (TBI). Methods A total of 132 young adult patients with TBI who underwent surgery and were then transferred to the intensive care unit in Department of Neurosurgery in Qingdao Municipal Hospital were enrolled as observation group, among whom 35 had mild TBI, 55 had moderate TBI, and 42 had severe TBI;50 young adult patients without TBI who were hospitalized and underwent cerebrospinal fluid puncture were enrolled as control group. Electrochemical luminescence was used to measure the levels of S100β, IL-1β, and IL-6 in serum and cerebrospinal fluid. The receiver operating characteristic (ROC) curve was used to observe the value of combined measurement of S100β, IL-1β, and IL-6 in the diagnosis of TBI, and the correlation of serum S100β, IL-1β, and IL-6 with the prognosis of TBI patients was analyzed. Results The patients with severe TBI had significantly higher levels of S100β, IL-1β, and IL-6 in serum and cerebrospinal fluid than those in the control group ( F =8.351-8.967, P <0.05). In the observation group, the levels of S100β, IL-1β, and IL-6 in serum were positively correlated with their levels in cerebrospinal fluid ( r =0.83-0.89, P <0.05). The measurement of serum S100β, IL-1β, or IL-6 alone had an area under the ROC curve of 0.810, 0.758, and 0.703, respectively, while combined measurement of serum S100β, IL-1β, and IL-6 had an area of 0.922. In the observation group, the expression levels of S100β, IL-1β, and IL-6 in serum and cerebrospinal fluid were negatively correlated with the prognosis of young adults with TBI ( F =8.671-9.371, P <0.05). Conclusion The levels of S100β, IL-1β, and IL-6 in serum and cerebrospinal fluid are closely associated with disease severity and prognosis of young adult patients with TBI, and combined measurement of S100β, IL-1β, and IL-6 has a higher diagnostic efficiency than the measurement of S100β, IL-1β, or IL-6 alone.