Protein-S-100-beta is increased in patients with decompensated cirrhosis admitted to ICU  

作　　者：Nicolas Weiss Simona Tripon Maxime Mallet Françoise Imbert-Bismut Mehdi Sakka Dominique Bonnefont-Rousselot Philippe Sultanik Sarah Mouri Marika Rudler Dominique Thabut 

机构地区：[1]Sorbonne Université,AP-HP.Sorbonne Université,Hôpital de la Pitié-Salpêtrière,Département de Neurologie,Unitéde Médecine Intensive RéanimationàOrientation Neurologique,Paris,France [2]Brain Liver Pitié-Salpêtrière(BLIPS)Study Group,INSERM UMR_S 938,Centre de recherche Saint-Antoine,Maladies métaboliques,Biliaires et Fibro-Inflammatoire du Foie,Institute of Cardiometabolism and Nutrition(ICAN),Paris,France [3]Groupe de Recherche Clinique en REanimation et Soins intensifs du Patient en Insuffisance Respiratoire aiguE(GRC-RESPIRE)Sorbonne Université,Paris,France [4]Assistance Publique-Hôpitaux de Paris,AP-HP.Sorbonne Université,Hôpital de la Pitié-Salpêtrière,Service d'hépato-Gastroentérologie,Unitéde Soins Intensifs d'Hépatologie,Paris,France [5]Assistance Publique-Hôpitaux de Paris,AP-HP.Sorbonne Université,Service de Biochimie Métabolique,Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix,DMU BioGeM,Paris F-75013,France [6]UniversitéParis Cité,UFR de Pharmacie,CNRS,Inserm,UTCBS,Paris,France

出　　处：《Journal of Intensive Medicine》2024年第2期222-230,共9页重症医学（英文）

基　　金：supported by the Fondation pour le Recherche Médicale(grant number:EQU202003010517).

摘　　要：Background Hepatic encephalopathy(HE)is highly prevalent in patients with liver diseases.The pathophysiology of HE is centered on the synergic role of hyperammonemia and systemic inflammation.However,some data suggest altered functioning of the blood–brain barrier(BBB).Assessing BBB function is challenging in clinical practice and at the bedside.Protein-S-100 Beta(PS100-Beta)could be a useful peripheral marker of BBB permeability in HE.This study aimed to assess plasmatic PS100-Beta levels in a prospective cohort of patients admitted to the intensive care unit(ICU)with decompensated cirrhosis with and without overt HE.Methods We retrospectively evaluated a prospective cohort of cirrhotic patients admitted to the ICU from October 2013 to September 2015 that had an available plasmatic PS100-Beta measurement.Patients with previous neurological impairment or limitation of intensive or resuscitative measures were excluded.Overt HE was defined as West-Haven grades 2 to 4.The patients were compared to a control cohort of outpatient clinic cirrhotic and non-cirrhotic patients explored for isolated elevation of liver enzymes.After ICU discharge,the patients were followed for at least 3 months for the occurrence of overt HE.Adverse outcomes(liver transplantation or death)were collected.The ability of PS100-Beta–in combination with other factors–to predict overt HE was evaluated in a multivariate analysis using logistic regression.Likelihood ratios were used to determine the effects and calculate odds ratios(OR).Survival analysis was performed by using the Kaplan–Meier method and survival between groups was compared using a Log-rank test.Results A total of 194 ICU patients and 207 outpatients were included in the study.Increased levels of plasmatic PS100-Beta were detected in the ICU decompensated cirrhotic patients compared with the outpatients([0.15±0.01]mg/L vs.[0.08±0]mg/L,P<0.001).ICU patients with overt HE had higher levels of PS100-Beta([0.19±0.03]mg/L)compared with the ICU patients without overt HE([0.13�

关 键 词：CIRRHOSIS Hepatic encephalopathy Blood-brain barrier PS100-Beta Liver disease 

分 类 号：R575.2[医药卫生—消化系统]