血清S100-β蛋白水平及血糖变异性与重型脑损伤预后的相关性临床研究

Clinical study on correlation between serum S100-βprotein level and blood glucose variability with prognosis of severe cerebral injury

目的探讨血清S100-β蛋白水平及血糖变异性在重型颅脑损伤患者中的变化,为重型颅脑损伤患者的预后评估提供可靠、全面的参考。方法选取急性生理与慢性健康评分Ⅱ≥15分、GCS评分≤8分的重型颅脑损伤患者41例,分别在患者入院时、入院第3天、入院第5天测量患者的血清S100-β蛋白水平及血糖值。结果重型颅脑损伤患者入院时血清S100-β蛋白水平及血糖值均明显升高,之后随着病情变化而变化,预后不良的患者入院时血清S100-β蛋白水平高于预后良好的患者,预后不良的患者血糖变异性显著高于预后良好的患者,差异有统计学意义(P<0.05),且血清S100-β蛋白水平与血糖变异性存在相关性(r=0.457,P<0.05)。结论血清S100-β蛋白水平及血糖变异性与重型颅脑损伤患者预后相关,可以作为对患者病情进行判断、对预后进行评估的重要指标。

Objective To explore the changes of serum S100-βprotein level and blood glucose variability in the patients with severe craniocerebral injury to provide reliable and comprehensive reference for their prognostic evaluation.Methods Forty-one patients with severe craniocerebral injury,the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)score≥15 points and the Glasgow Coma Scale(GCS)scores≤8 points were selected and their blood glucose and serum S100-β protein levels were measured at admission,on 3,5 d after admission.Results The serum S100-βprotein and blood glucose levels at admission in the patients with severe craniocerebral injury were significantly increased,and then changed with the change of the disease condition.The serum S100-βprotein level at admission in the patients with poor prognosis was significantly higher than that in the patients with good prognosis,and the blood glucose variability in the patients with poor prognosis was significantly higher than that in the patients with good prognosis,and the differences were statistically significant(P<0.05).There was a correlation between serum S100-βprotein level and blood sugar variability(r=0.457,P<0.05).Conclusion Serum S100-βprotein level and blood glucose variability are correlated with the prognosis in the patients with severe craniocerebral injury,and can be used as the important indexes for judging the patient′s condition and evaluating the prognosis.