Woertgen Chris, Albert Ruth, Köhler Markus, Rzepecki Angela, Rothoerl Ralf Dirk, Bein Thomas, Brawanski Alexander
Department of Neurosurgery, University of Regensburg, 93042, Germany.
Neurosurg Rev. 2004 Jul;27(3):178-80. doi: 10.1007/s10143-004-0341-x. Epub 2004 May 1.
Serum markers, e.show $132#g., the protein S-100B and neuron-specific enolase (NSE), are recognized to give additional information about the extension and prognosis of brain damage. In some of these patients it is necessary to insert a ventricular drain. Whether the cannulation of the ventricle falsifies the serum concentrations of these markers is unknown. The aim of this study was to get further information in this field. In this prospective study we included 19 patients. All patients underwent ventricular tapping and insertion of a ventricular drain. Serum samples for estimation of S-100B and NSE were collected before, directly after and 6 h after insertion. In addition we investigated the cerebrospinal fluid (CSF) directly after and 6 h after insertion. All patients but one showed no significantly increased S-100B or NSE serum concentration after insertion of the drainage. The concentrations in the CSF were significantly higher. One patient showed increasing concentrations of the markers in all samples reflecting ongoing brain damage. The serum values of S-100B and NSE seem not to be falsified by insertion of a ventricular drain. Therefore the prognostic value of these serum markers seems to be preserved despite the surgical manipulation.
血清标志物,例如蛋白质S - 100B和神经元特异性烯醇化酶(NSE),被认为能提供有关脑损伤范围和预后的额外信息。在其中一些患者中,有必要插入脑室引流管。脑室插管是否会伪造这些标志物的血清浓度尚不清楚。本研究的目的是在该领域获取更多信息。在这项前瞻性研究中,我们纳入了19名患者。所有患者均接受了脑室穿刺和脑室引流管插入。在插入前、插入后即刻以及插入后6小时采集用于评估S - 100B和NSE的血清样本。此外,我们在插入后即刻和插入后6小时对脑脊液(CSF)进行了检测。除一名患者外,所有患者在插入引流管后S - 100B或NSE血清浓度均未显著升高。脑脊液中的浓度显著更高。一名患者所有样本中的标志物浓度均升高,反映出脑损伤仍在持续。插入脑室引流管似乎并未伪造S - 100B和NSE的血清值。因此,尽管进行了手术操作,这些血清标志物的预后价值似乎仍得以保留。