β2-微球蛋白、S100B钙结合蛋白在颅脑损伤术后脑脊液中的表达与交通性脑积水发生的相关性

Correlation between the expression of β2-microglobulin and S100 calcium binding protein B in cerebrospinal fluid and the occurrence of communicating hydrocephalus after traumatic brain injury

目的探讨β2-微球蛋白(β2-MG)、S100B钙结合蛋白(S100B)在颅脑损伤术后脑脊液中的表达与交通性脑积水发生关系。方法选择2016年5月至2019年6月宁波市第七医院、波市镇海龙赛医院、浙江大学医学院附属第二医院收治的298例颅脑损伤患者为病例组,同期在我院体检健康者100例为对照组,比较对照组与病例组脑脊液中β2-MG、S100B水平,根据298例颅脑损伤患者术后是否发生交通性脑积水分为非交通性脑积水组(n=247)与交通性脑积水组(n=51),比较非交通性脑积水组与交通性脑积水组脑脊液中β2-MG、S100B水平,采用Spearman相关分析颅脑损伤患者术后脑脊液中β2-MG、S100B水平与交通性脑积水的相关性,采用受试者工作特征曲线(ROC)分析颅脑损伤患者术后脑脊液中β2-MG、S100B水平对交通性脑积水的预测价值。采用χ2检验及t检验。结果交通性脑积水组脑脊液中β2-MG、S100B水平显著高于非交通性脑积水组(P<0.05);颅脑损伤患者术后脑脊液中β2-MG、S100B水平与交通性脑积水呈正相关(P<0.05);颅脑损伤患者术后脑脊液中β2-MG、S100B联合预测交通性脑积水的曲线下面积(AUC)、敏感性、特异性、准确性依次为0.925、77.90%、96.00%、91.65%。结论β2-MG、S100B在颅脑损伤术后脑脊液中呈高表达,β2-MG、S100B在颅脑损伤术后脑脊液中高表达与交通性脑积水发生有相关,颅脑损伤患者术后脑脊液中β2-MG>2.04 mg/L且S100B>0.41μg/L对交通性脑积水有较高的预测价值。

Objective:To investigate correlation between the expression ofβ2-microglobulin(β2-MG)and S100 calcium binding protein B(S100B)in cerebrospinal fluid and the occurrence of communicating hydrocephalus after traumatic brain injury.Methods:Two hundreds and ninty-eight patients with craniocerebral injury(case group)and 100 healthy individuals(control group)in our hospital from May 2016 to June 2019 were enrolled,and the case group was further divided into two subgroups according to the absence and presence of communicating hydrocephalus,non-communicating hydrocephalus group(n=247)and communicating hydrocephalus(n=51).Theβ2-MG and S100B levels in cerebrospinal fluid were compared between groups and subgroups.Spearman correlation was used to analyze the correlation betweenβ2-MG and S100B levels and communicating hydrocephalus in patients with craniocerebral injury after operation.The receiver operating characteristic curve(ROC)was used to analyze the predictive value ofβ2-MG and S100B levels in postoperative cerebrospinal fluid for communicating hydrocephalus in patients with traumatic brain injury.Results:The levels ofβ2-MG and S100B in the cerebrospinal fluid of the communicating hydrocephalus group were significantly higher than those of the non-communicating hydrocephalus group(P<0.05);The levels ofβ2-MG and S100B in cerebrospinal fluid of patients with traumatic brain injury were positively correlated with communicating hydrocephalus(P<0.05);The area under curve(AUC),sensitivity,specificity and accuracy of combined detection ofβ2-MG and S100B for communicating hydrocephalus were 0.925,77.90%,96.00%and 91.65%respectively.Conclusion:The elevated expression ofβ2-MG and S100B in cerebrospinal fluid after craniocerebral injury surgery is significantly correlated with the occurrence of communicating hydrocephalus,and combined detection of the two after craniocerebral injury has a high predictive value for communicating hydrocephalus.