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急性自发性脑出血后的血浆S100B水平。

Plasma S100B level after acute spontaneous intracerebral hemorrhage.

作者信息

Delgado Pilar, Alvarez Sabin Jose, Santamarina Esteban, Molina Carlos A, Quintana Manuel, Rosell Anna, Montaner Joan

机构信息

Neurovascular Research Laboratory, Stroke Unit, Departament de Medicina, Universitat Autònoma de Barcelona, Hospital General Vall d'Hebron, Barcelona, Spain.

出版信息

Stroke. 2006 Nov;37(11):2837-9. doi: 10.1161/01.STR.0000245085.58807.ad. Epub 2006 Sep 28.

Abstract

BACKGROUND AND PURPOSE

We sought to determine plasma S100B level after acute (<24 hours) spontaneous intracerebral hemorrhage (ICH) and to study its relation with neurological outcome.

METHODS

We determined S100B concentration on plasma samples from 78 ICH patients on admission. Clinical (Glasgow Coma Scale and National Institutes of Health Stroke Scale [NIHSS] scores) and radiological information (ICH and perihematomal edema volumes) were collected at baseline and follow-up visits. Early neurological deterioration, defined as the increase of >or=4 points in the NIHSS score at 48 hours, and unfavorable outcome (modified Rankin Scale >2) at 3 months were also recorded.

RESULTS

The median S100B level was higher than our laboratory reference values for healthy controls (103.6 versus 48.5 pg/mL; P<0.001) and a positive correlation was observed between S100B level and baseline ICH volume (r=0.45; P<0.0001). The median S100B level was higher in patients who deteriorated early (256.8 versus 89.7 pg/mL; P=0.001) and also in patients with an unfavorable outcome (136 versus 75.9 pg/mL; P=0.003). Multivariate analysis showed baseline ICH volume as the best predictor for both early neurological deterioration (odds ratio 15; 95% CI, 2.9 to 76.3) and unfavorable outcome at 3 months (odds ratio 17; 95% CI, 2.0 to 142).

CONCLUSIONS

Increased S100B level is found after acute spontaneous ICH, in association with a worse early and late evolution, and closely related to initial hematoma volume.

摘要

背景与目的

我们试图测定急性(<24小时)自发性脑出血(ICH)后的血浆S100B水平,并研究其与神经功能转归的关系。

方法

我们测定了78例ICH患者入院时血浆样本中的S100B浓度。在基线期和随访时收集临床信息(格拉斯哥昏迷量表和美国国立卫生研究院卒中量表[NIHSS]评分)及影像学信息(ICH和血肿周围水肿体积)。还记录了早期神经功能恶化情况,定义为48小时时NIHSS评分增加≥4分,以及3个月时不良转归(改良Rankin量表>2)。

结果

S100B水平中位数高于我们实验室健康对照的参考值(103.6对48.5 pg/mL;P<0.001),且观察到S100B水平与基线ICH体积之间存在正相关(r=0.45;P<0.0001)。早期恶化患者的S100B水平中位数更高(256.8对89.7 pg/mL;P=0.001),不良转归患者也是如此(136对75.9 pg/mL;P=0.003)。多变量分析显示,基线ICH体积是早期神经功能恶化(比值比15;95%CI,2.9至76.3)和3个月时不良转归(比值比17;95%CI,2.0至142)的最佳预测指标。

结论

急性自发性ICH后发现S100B水平升高,与早期和晚期病情转归较差相关,且与初始血肿体积密切相关。

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