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创伤性脑损伤后的血清S-100B蛋白和神经元特异性烯醇化酶

[Serum S-100B protein and neuron-specific enolase after traumatic brain injury].

作者信息

Sawauchi Satoshi, Taya Keisuke, Murakami Shigeyuki, Ishi Takuya, Ohtsuka Toshihiro, Kato Naoki, Kaku Shougo, Tanaka Toshihide, Morooka Satoru, Yuhki Kenji, Urashima Mitsuyoshi, Abe Toshiaki

机构信息

Department of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan.

出版信息

No Shinkei Geka. 2005 Nov;33(11):1073-80.

Abstract

OBJECTIVE

The aim of this study was to investigate S-100B protein and NSE as a serum marker of brain cell damage after traumatic brain injury.

MATERIAL AND METHODS

Forty-one patients with traumatic brain injury were included in this prospective study. Venous blood samples for S-100B protein and NSE were taken after admission and on the next day. Serum levels of S-100 protein and NSE were compared with Glasgow Coma Scale score, computed tomographic findings and outcome after 3 months.

RESULTS

Serum S-100B protein and NSE were significantly correlated with Glasgow Coma Scale score and outcome after 3 months. The significant correlation was found between the initial S-100B and NSE (P < 0.001). In patients without parenchymal injuries on computed tomographic scan such as epidural hematoma and concussion, the elevation of S-100B protein and NSE was observed. The initial values of S-100B and NSE in acute subdural hematomas with unfavorable outcome were significantly higher than in those with favorable outcome. Secondary increase of serum markers was associated with the presence of secondary insult such as hypoxia or hypotension, and was found to have an unfavorable outcome.

CONCLUSIONS

Serum concentration and kinetics of S-100B protein and NSE provide the clinical assessment of the primary brain damage and have a predictive value for outcome after traumatic brain injury.

摘要

目的

本研究旨在探讨S-100B蛋白和神经元特异性烯醇化酶(NSE)作为创伤性脑损伤后脑细胞损伤的血清标志物。

材料与方法

本前瞻性研究纳入了41例创伤性脑损伤患者。入院时及次日采集静脉血样本检测S-100B蛋白和NSE。将S-100蛋白和NSE的血清水平与格拉斯哥昏迷量表评分、计算机断层扫描结果及3个月后的预后进行比较。

结果

血清S-100B蛋白和NSE与格拉斯哥昏迷量表评分及3个月后的预后显著相关。初始S-100B和NSE之间存在显著相关性(P < 0.001)。在计算机断层扫描无实质损伤(如硬膜外血肿和脑震荡)的患者中,观察到S-100B蛋白和NSE升高。预后不良的急性硬膜下血肿患者的S-100B和NSE初始值显著高于预后良好的患者。血清标志物的二次升高与缺氧或低血压等二次损伤的存在相关,且被发现预后不良。

结论

S-100B蛋白和NSE的血清浓度及动力学可为原发性脑损伤提供临床评估,并对创伤性脑损伤后的预后具有预测价值。

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