Rosén H, Sunnerhagen K S, Herlitz J, Blomstrand C, Rosengren L
Institute of Clinical Neuroscience, Department of Neurology, Sahlgrens University Hospital, University of Gôteborg, S-413 45, Göteborg, Sweden. hans.rosen@
Resuscitation. 2001 May;49(2):183-91. doi: 10.1016/s0300-9572(00)00348-8.
patients with cardiac arrest have a high mortality and the long-term outcome is doubtful. The prognosis is mainly dependent on clinical parameters. S-100 and neurone specific enolase (NSE) are established biochemical markers of central nervous system (CNS) injury. The purpose of this study was to validate the use of serum determinations of S-100 and NSE with neurological investigations in regard to brain damage and long-term outcome after cardiac arrest.
neurological examinations were performed on 66 patients after cardiac arrest. Serum levels of S-100 and NSE were determined during the first 3 days of post arrest, using commercial luminescent immunoassays (LIAs). The main outcome variable was the Glasgow Outcome Scale (GOS), while secondary variables were the activity of daily living (ADL) index and mini mental state examination (MMSE). Outcome was determined at 1 year.
the serum levels of S-100 and NSE were increased during the first 3 days after the arrest and were related to coma depth, time of anoxia and abnormal brain stem reflexes. High levels predicted a poor outcome, according to the GOS (death, vegetative state and severe disability). The prognostic value of the brain damage markers was comparable with that of traditional clinical parameters. None of the secondary outcome variables (ADL and MMSE) was strongly associated with S-100 or NSE.
the serum levels of S-100 and NSE increased after cardiac arrest due to the anoxic brain damage. The determination of S-100 and NSE can be used as an adjunct to predict long-term outcome after cardiac arrest.
心脏骤停患者死亡率高，长期预后不明。预后主要取决于临床参数。S-100和神经元特异性烯醇化酶（NSE）是公认的中枢神经系统（CNS）损伤的生化标志物。本研究旨在验证血清S-100和NSE测定联合神经学检查在评估心脏骤停后脑损伤及长期预后方面的应用价值。
对66例心脏骤停后的患者进行神经学检查。使用商业发光免疫分析法（LIAs）在心脏骤停后的头3天内测定血清S-100和NSE水平。主要结局变量为格拉斯哥预后量表（GOS），次要变量为日常生活活动（ADL）指数和简易精神状态检查（MMSE）。在1年时确定结局。
心脏骤停后头3天内血清S-100和NSE水平升高，且与昏迷深度、缺氧时间及脑干反射异常有关。根据GOS（死亡、植物状态和严重残疾），高水平预示预后不良。脑损伤标志物的预后价值与传统临床参数相当。次要结局变量（ADL和MMSE）均与S-100或NSE无强关联。
心脏骤停后因缺氧性脑损伤血清S-100和NSE水平升高。S-100和NSE的测定可作为预测心脏骤停后长期预后的辅助手段。
