脑肿瘤切除术前后血清S100B蛋白水平的改变  

Perioperative serum level of S100B in patients undergoing brain tumor resection

作　　者：蓝川琉 谭源福[1] 曾湖[1] 肖绍文[1] 张超元[1] 郑传华 

机构地区：[1]广西医科大学第一附属医院神经外科,南宁530021

出　　处：《临床神经外科杂志》2016年第4期296-300,共5页Journal of Clinical Neurosurgery

基　　金：广西壮族自治区教育厅高校科研项目(桂教YB2014078)

摘　　要：目的研究脑肿瘤手术前后血清S100B蛋白水平的改变,并分析其与患者临床资料的相关性,评估血清S100B对术后脑损伤的反映能力。方法 30例胶质瘤、28例脑膜瘤和15例听神经瘤患者于手术前(入院时)、手术后第1 d、第3 d、第7 d分别采集血清;同时记录患者手术时长、肿瘤WHO级别、肿瘤体积、脑水肿体积、KPS等临床资料。设正常对照组33例,采集单次血清。用双抗体夹心法ELISA检测血清S100B含量。将手术前后血清S100B水平进行重复测量方差分析;将血清S100B水平与手术时长、肿瘤体积等临床资料进行相关性分析。结果术前血清S100B水平在各脑肿瘤组之间的差异无统计学意义(P>0.05),胶质瘤组、脑膜瘤组则高于正常对照组(均P<0.05)。术后第1 d、第3 d血清S100B含量无明显改变(P>0.05),术后第7 d时高于手术前水平(P<0.05),这种趋势在3个脑肿瘤组之间并无差别。在胶质瘤组中,术后第3、7 d血清S100B含量与术后脑水肿体积呈正相关(均P<0.05);术后第1 d、第3 d血清S100B含量与胶质瘤病理级别呈正相关(均P<0.05)。在听神经瘤组中,手术前、术后第3 d血清S100B含量与听神经瘤肿瘤体积呈负相关(均P<0.05),术后第7 d血清S100B水平与手术时长呈正相关(P<0.05)。脑膜瘤组内未见任何相关性。结论血清S100B对脑肿瘤切除术后的脑损伤反映较差,其含量升高可能与损伤后神经修复活动有关。血清S100B含量与胶质瘤的病理级别、术后脑水肿程度有一定的相关性,与听神经瘤体积及手术时长存在相关性。脑肿瘤术前血清S100B升高可能反映了肿瘤对脑实质的压迫损伤。Objective Brain tumor resection could cause brain damage and may affect patient＇s prognosis .It is supposed that S 100 B level may reflect the extend of brain insults .In this study , we explore how serum S100B changes perioperatively and whether it correlate with patient＆#39;s clinical data （such as tumor volume , duration of operation, etc.）.Method There is 30 glioma patients, 28 meningiomas and 15 acoustic tumor patients included .All patient＇s blood sample were collected on admission and at postoperative day 1, 3 and 7.And the patient＇s clinical data （ such as tumor volume , peritumor edema , grading by WHO classification , duration of operation , patient＇s Karnofsky Performance Scale , etc.） were recorded at the mean time .There is also 33 healthy adults from the medical examination center of the same hospital to be a control group and whose blood sample were collect just for once .We use a commercial ELISA kit to quantify serum level of S 100B. A repeated measure ANOVA is conduct to test among previous and post operative serum levels of S100B.And correlation analysis was made between serum S 100B and patients clinical data .Result The S100 B serum levels among glioma , meningioma and acoustic tumor patients has no statistically difference（P〉0.05）,and levels of S100B in both glioma and meningioma patients are higher than the control＇s（all P〈0.05）, except for the acoustic tumor group＇s.There is no difference among the three groups in perioperative change of serum S 100B （ P 〉0.05 ）： Serum S100B levels in post operatively day 1 and day 3 has no change compared to its previous operative levels （ P〉0 .05 ） , while serum S100B levels in post operatively day 7 is higher than the previous operative levels （ P〈0.05）.The correlation between post operative brain edema and serum S 100B is seen in the glioma patients in postoperative day 3 and 7 （ all P〈0 .05 ） and between the grade of WHO classification of tumor and serum S100B is seen in glioma patients in po

关 键 词：血清 S100B 脑肿瘤 颅脑手术 术后脑损伤 

分 类 号：R651.1[医药卫生—外科学]