S-100B,NSE和MBP评估重型颅脑损伤预后的研究

Role of S-100B,NSE and MBP in Prediction of Prognosis in Patients with Severe Head Injury

目的研究重型颅脑损伤后血清S-100B蛋白、神经特异性烯醇化酶(NSE)和碱性髓鞘蛋白(MBP)浓度在预后评估中的价值。方法对2002年1月至2002年12月40例重型颅脑损伤住院病人在伤后12h内进行血清S-100B、NSE和MBP浓度检测,并结合GOS评分进行比较分析。结果本组40例重型颅脑损伤病人伤后血清S-100B、NSE和MBP浓度均显著高于正常对照组,不同预后组之间S-100B、NSE和MBP浓度存在显著差异。分别以伤后12h血清S-100B浓度2.0μg/L、NSE浓度30ng/ml和MBP浓度10ng/ml为分界标准评估预后,S-100B评估预后的特异度为91%,敏感度72%;NSE特异度为77%,敏感度67%;MBP特异度为63%,敏感度61%。结论伤后血清S-100B蛋白、NSE和MBP浓度对评估重型颅脑损伤预后具有较高的特异性和敏感性。而S-100B浓度在预后评估中的作用较NSE和MBP更为敏感,特异,因此可作为评估重型颅脑损伤预后的一种可靠的临床指标。

Objective To elucidate the role of S-100B, NSE and MBP in predicting the prognosis in patients with severe head injury. Methods The concentrations of S-100B, NSE and MBP in serum were measured within 12 hours after the injury in 40 patients with severe head injury who were treated in our department from January to December 2002. And outcomes of all the patients were evaluated by GOS 2 months after the injury. Results The serum concentrations of S-100B, NSE and MBP after the injury in 40 patients with severe head injury were higher than those in the normal control group. There were significant difference in the serum concentrations of s-100B, NSE and MBP between the good prognosis group and the poor prognosis group. The their concentrations within 12 hours after head injuries were closely related with the prognosis. Furthermore, according to the ROC curves of S-100B, NSE and MBP, S-100B was more valuable for predicting prognosis in the patients with severe head injury. Conclusions The present results suggest that S-100B, NSE and MBP may play important roles in predicting the prognosis in the patients with severe head injury. But S-100B may be a more promising predictor of the prognosis in the patients with severe head injury.