重型颅脑损伤患者血浆S-100B蛋白测定的临床意义  

Clinical significance of serum S-100B protein in severe cerebral injury

作　　者：胡殿雷[1] 柳宪华 于效良 郭红梅[2] 郭兵[2] 石岩[3] 庄会林 施鹏[1] 

机构地区：[1]江苏省徐州市第三人民医院神经外科,221005 [2]江苏省徐州市第三人民医院检验科,221005 [3]江苏省徐州市第三人民医院CT室,221005

出　　处：《中国危重病急救医学》2004年第4期221-222,共2页Chinese Critical Care Medicine

基　　金：江苏省徐州市科技局基金资助项目 (X2 0 0 10 5 6) ;徐州市卫生局青年科技基金资助项目 (XQ2 0 0 0 0 4)

摘　　要：目的　探讨血浆 S 10 0 B蛋白作为一种生物学指标在重型颅脑损伤诊断及预后判断中的应用价值。方法　重型颅脑损伤患者 6 6例 ,伤后早期 (2～ 6 h)抽取血浆标本 ,并从伤后 2 4 h起连续 3～ 7d检测血浆 S 10 0 B蛋白含量 ,将其结果与患者伤后 6个月格拉斯哥预后评分 (GOS)进行比较。结果　 6 6例患者中死亡 2 5例 ,致残 2 2例 ,良好 19例。死亡组 S 10 0 B平均 2 .6 0 μg/ L,明显高于存活组 (0 .5 5 μg/ L,P<0 .0 0 1) ;死亡组中有 14例 S 10 0 B峰值超过 2 .0 0 μg/ L,而存活组中只有 4例峰值超过 2 .0 0 μg/ L(P<0 .0 0 5 )。结论　血浆 S 10 0 B蛋白在重型颅脑损伤的诊断及预后判断中具有可靠的应用价值。ObjectiveTo investigate the value of S100B protein as a biology marker in diagnosis and prognostic after severe cerebral injury. MethodsSixtysix patients with severe head injury〔Glasgow coma scale score(GCS)≤8〕 were included in this study,venous blood samples for S100B protein were obtained as soon as possible after admission and every 24 hours thereafter for a maximum of 3～7 consecutive days. Serum levels of S100B protein were compared with outcome(Glasgow outcome scale score,GOS) after 6 months . ResultsOf 66 patients,25 patients died,mutilation in 22 patients,19 patients had a good outcome . Patients who died had significantly higher serum S100B values compared with those who survived (median 2.60 μg/L vs. 0.55 μg/L,P<0.001),14 of 25 patients who died had peak S100B values of 2.00 μg/L or higher,compared with 4 of 41 surviving patients (P<0.005). Conclusion S100B protein has a reliable value in diagnosis and prognostic after severe head injury.

关 键 词：颅脑损伤 重型 S-100B蛋白 预后 

分 类 号：R651.15[医药卫生—外科学]