急性脑梗死患者S-100蛋白的动态变化及其临床意义

The Clinical significance of serially determination of protein S-100 in patients with ischemic stroke

目的 观察脑梗死患者血浆 S- 10 0蛋白的浓度变化 ,并评价其临床意义。方法 应用 EL ISA法对35例急性脑梗死患者的血浆 S- 10 0蛋白水平进行动态检测 ,同时应用 NIHSS进行神经功能缺损评分及 CT扫描 ,并与 30例对照组患者进行比较。结果 病例组患者 S- 10 0浓度明显升高 ,2～ 3d达到峰值 ,且有严重神经功能缺失的患者 ,S- 10 0升高更明显 ,S- 10 0 >1.0μg/ L、NIHSS 12分提示患者预后不良。结论 缺血性脑梗死后血浆中 S- 10 0蛋白的出现与坏死的神经胶质细胞漏出有关 ,并通过受损的血脑屏障进入血液 ,S- 10 0蛋白可作为缺血性脑损伤尤其是大面积脑梗死早期的外周标志物 ,是比 CT更为敏感的指标 ,对指导治疗有帮助。

Objective Observation of protein S 100 in plasma after cerebral infarction,and discuss its clinical significance.Methods S 100 plasma levels were serially determined in 35 patients with an acute infarction and in 30 control subjects.S 100 assays were performed by using ELISA.The neurological status was evaluated by the National Institutes of Health Stroke Scale (NIHSS) and a cranial computed tomography (CCT) was performed at initially and 10d.Results The concentrations of S 100 were higher in patients with cerebral infarction,and peaked at day 2~3d after stroke. The S 100 concentrations in plasma were significantly higher in patients with severe neurological deficits at adimission.S 100>1.0μg/l and NIHSS > 12 point indicated poor outcome.Conclusion Presence of S 100 in plasma after ischemic stroke may be due to combined leakage of necrotic glial cells and passage through an impaired brain blood barrier,indicating severe ischemic cell injury,therefore S 100 in plasma can be used as a peripheral marker of ischemic focal brian damage,especial of big size of brain lesion.It may be helpful for therapeutic decisions in acute ischemic stroke.