脑损害标志物动态检测在颅脑损伤病人预后判断中的价值  

Changes of Neurobiochemical markers of Brain damage and Values in Outcome after Craniocerebral Injury

作　　者：王寿先[1] 王成东[1] 武丽丽[1] 逄迎春[1] 张振兴[1] 

机构地区：[1]潍坊医学院附属潍坊市人民医院神经外科,山东潍坊261041

出　　处：《潍坊医学院学报》2006年第1期9-11,T0001,共4页Acta Academiae Medicinae Weifang

摘　　要：目的探讨脑损害标志物（NSE和S100B）在颅脑损伤后的动态变化及其在预后判断中的意义。方法ELISA法动态检测140例颅脑损伤患者血NSE和S100B水平。出院时按GOS分级判断预后。结果①伤后初期（24h内）外伤组NSE和S100B含量均较对照组明显升高，随病情的发展于伤后3～10d出现迅速降低、持续高值或继发性升高；②预后不良组NSE和S100B含量均明显高于预后良好组（P〈0．05），重残组、中残组和恢复良好组间NSE和S100B蛋白水平变化均有明显不同，NSE和S100B蛋白有相似的变化模式；③ROC曲线结果表明S100B蛋白判定预后的价值较NSE大（P〈0．05）。二者并联的诊断敏感性为95％，特异性为89％；二者串联的敏感性为95％，特异性为89％；均高于单一指标检测（P〈0．05）。结论NSE和S100B水平变化与患者病情和预后密切相关，二者联合检测具有更高的预后判断价值。Objective To investigate the changes of neurobiochemical markers （NSE and S100B） of brain damage and their values in outcome after craniocerebral injury. Methods Dynamicly detecting the levels of blood NSE and S100B of 140 patients with craniocerebral iniury by ELISA. According to GOS grading at discharge. Results ①Post-traumatic initial stage （in 24h）, contents of NSE and S100B of traumatic group is increased obviously （P 〈 0.05） than control group, in 3 to 10 days appearing rapidly lower and steadily high level or secondary increase following the developing of patient＇s condition. ②The levels of NSE and S100B detected within 24h were significantly increased （P 〈 0.05） in poor outcome group, compared with the good outcome group. There are a similar time course of the changes of NSE and S100B protein. ③ROC cures suggested S100B protein has higher predict values than NSE （P 〈 0.05）. And their associated detection has a higher sentitivity and specificity than singel index （either： se-95%, sp-89%; both： se-83%, sp-91%）. Conclusion The changes of blood NSE and S100B protein leves are associated with patient＇s condition and outcome, and their associated detection （either or both） is advantage of singgel index.

关 键 词：颅脑损伤 神经元特异性烯醇化酶 S100B蛋白 联合检测 

分 类 号：R446.6[医药卫生—诊断学] R651.1[医药卫生—临床医学]