Woertgen C, Rothoerl R D, Metz C, Brawanski A
Department of Neurosurgery, University of Regensburg, Germany.
J Trauma. 1999 Dec;47(6):1126-30. doi: 10.1097/00005373-199912000-00026.
S-1OOB, a protein of astroglial cells, is described as a marker for neuronal damage. Reliable outcome prediction from severe head injury is still unresolved. Clinical scores such as the Glasgow Coma Scale score (GCS) and diagnostic scores such as the Marshall Computed Tomographic Classification are well established and investigated, but there are still some concerns about these tools. The aim of this study was to investigate the predictive value of the initial serum level of S-100B compared with the predictive value of the GCS score and the Marshall Computed Tomographic Classification to outcome after severe head injury.
Forty-four patients with severe head injury (GCS score < 9) were included. Blood samples were drawn within 1 to 6 hours of injury. After a period of 11 months, their outcome was correlated by using the Glasgow Outcome Scale. Patients with an S-100B serum level above 2 microg/L, a GCS score between 3 and 5, and a computed tomographic scan in the categories 4 to 6 are predicted to have an unfavorable outcome. The predictive values of these tools were calculated according to these definitions.
The protein S-100B had with 17% the lowest total misclassification rate. When compared with the GCS score and Marshall Computed Tomographic Classification the S-100B serum level calculated on admission had the highest positive predictive value (87%) and negative predictive value (77%).
The serum level of S-100B calculated within 1 to 6 hours of a severe head injury is a useful additional outcome predictor.
S-100B是一种星形胶质细胞蛋白，被描述为神经元损伤的标志物。严重颅脑损伤的可靠预后预测仍未解决。诸如格拉斯哥昏迷量表评分（GCS）等临床评分以及诸如马歇尔计算机断层扫描分类等诊断评分已得到充分确立和研究，但对这些工具仍存在一些担忧。本研究的目的是调查与GCS评分和马歇尔计算机断层扫描分类对严重颅脑损伤后预后的预测价值相比，初始血清S-100B水平的预测价值。
纳入44例严重颅脑损伤患者（GCS评分<9）。在受伤后1至6小时内采集血样。11个月后，使用格拉斯哥预后量表对其预后进行相关性分析。血清S-100B水平高于2μg/L、GCS评分为3至5分且计算机断层扫描类别为4至6类的患者预计预后不良。根据这些定义计算这些工具的预测价值。
蛋白S-100B的总错误分类率最低，为17%。与GCS评分和马歇尔计算机断层扫描分类相比，入院时计算的S-100B血清水平具有最高的阳性预测值（87%）和阴性预测值（77%）。
在严重颅脑损伤后1至6小时内计算的S-100B血清水平是一种有用的额外预后预测指标。
