Weglewski Arkadiusz, Ryglewicz Danuta, Mular Anna, Juryńczyk Jacek
Oddział Neurologii, Szpital Wojewódzki im. Jana Pawła II, ul. Czapliniecka 123, 97-400 Bełchatów.
Neurol Neurochir Pol. 2005 Jul-Aug;39(4):310-7.
Biochemical markers offer a new strategy in the diagnosis, estimation of clinical prognosis and monitoring of treatment in patients with brain damage. At present, two specific brain originated proteins play a major role: S100B protein and neuron-specific enolase (NSE). S100B comes from astrocytes and NSE has been found in neuronal cytoplasm. The aim of this study was to evaluate dynamics of protein S100B level changes in blood in stroke patients.
The material consisted of 67 patients, 53 with ischemic stroke (mean age 67.7) and 14 with hemorrhagic stroke (mean age 66.7). The diagnosis of stroke was made on the basis of clinical symptoms and computed tomography (CT). Plasma concentration of S100B was measured using the immunoluminometric test (Lia-Mat Sangtec 100(R)) on the 1st, 3rd, 7th and 14th day after stroke onset.
The highest levels of protein S100B were found in ischemic stroke predominantly on the 3rd day and in hemorrhagic stroke on the 1st day. The concentrations of protein S100B were similar in ischemic and hemorrhagic stroke on the 3rd, 7th and 14th day but they were significantly higher on the 1st day in hemorrhagic stroke. Serum levels of protein S100B after stroke onset have shown a correlation with infarct volume, especially in patients with large or medium stroke. In small stroke lesions, concentrations of protein S100B were under the cut-off level. In hemorrhagic stroke protein S100B levels were higher in patients with midline shift visible in brain CT, but the differences were not significant.
Ischemic and hemorrhagic strokes lead to release of protein S100B into the blood. A good correlation between the release pattern of S100B and volume of vascular lesion has been found. S100B protein is the marker of brain damage during stroke. It is possible to use protein S100B measurements in monitoring the stroke treatment.
生化标志物为脑损伤患者的诊断、临床预后评估及治疗监测提供了一种新策略。目前,两种特定的脑源性蛋白发挥着主要作用:S100B蛋白和神经元特异性烯醇化酶(NSE)。S100B来自星形胶质细胞,NSE存在于神经元细胞质中。本研究的目的是评估中风患者血液中S100B蛋白水平变化的动态情况。
研究材料包括67例患者,其中53例为缺血性中风(平均年龄67.7岁),14例为出血性中风(平均年龄66.7岁)。中风的诊断基于临床症状和计算机断层扫描(CT)。在中风发作后的第1天、第3天、第7天和第14天,使用免疫发光法(Lia-Mat Sangtec 100(R))测量血浆中S100B的浓度。
缺血性中风患者中,S100B蛋白水平最高主要出现在第3天;出血性中风患者则出现在第1天。在第3天、第7天和第14天,缺血性和出血性中风患者的S100B蛋白浓度相似,但出血性中风患者在第1天的浓度显著更高。中风发作后血清S100B蛋白水平与梗死体积相关,尤其是在中大型中风患者中。在小中风病灶中,S100B蛋白浓度低于临界值。在出血性中风中,脑部CT显示有中线移位的患者S100B蛋白水平较高,但差异不显著。
缺血性和出血性中风均导致S100B蛋白释放到血液中。已发现S100B的释放模式与血管病变体积之间具有良好的相关性。S100B蛋白是中风期间脑损伤的标志物。在中风治疗监测中使用S100B蛋白测量是可行的。