Townend Will, Ingebrigtsen Tor
Emergency Department, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK.
Injury. 2006 Dec;37(12):1098-108. doi: 10.1016/j.injury.2006.07.014. Epub 2006 Oct 30.
Prediction of the likely outcome of head injury from the outset would allow early rehabilitation to be targeted at those with most to gain. Clinical evaluation of a head injured patient may be confounded by intoxicants such as alcohol. Imaging modalities are insensitive (CT) or impractical (MR) for screening populations of such patients. A peripheral marker that reflected the extent of brain injury might offer an objective indication of likely adverse sequelae. This review evaluates the evidence for Protein S-100B as such a marker.
A search of published literature revealed 18 studies designed to evaluate the relation between serum S-100B and measures of outcome after head injury.
A cut-off point of 2.5microg/L is related to dependent disability in those presenting with low conscious level, and may be a specific test for this. There appears to be a relation between initial serum S-100B concentration and measures of disability as well as post-concussion symptoms for those with seemingly mild injuries. There does not appear to be a relation between S-100B and measures of neuropsychological performance.
Patients with high levels of S-100B at initial assessment (>2.5microg/L) may represent a high risk group for disability after head trauma.
从一开始就预测头部损伤的可能结果，将使早期康复能够针对那些受益最大的患者。头部受伤患者的临床评估可能会因酒精等 intoxicants 而混淆。成像方式对于对此类患者群体进行筛查而言不敏感（CT）或不实用（MR）。一种反映脑损伤程度的外周标志物可能会为可能的不良后遗症提供客观指标。本综述评估了蛋白 S-100B 作为此类标志物的证据。
对已发表文献的检索发现了 18 项旨在评估血清 S-100B 与头部损伤后预后指标之间关系的研究。
2.5μg/L 的临界值与意识水平低的患者的依赖性功能障碍有关，并且可能是对此的一项特异性检测。对于那些看似轻度损伤的患者，初始血清 S-100B 浓度与功能障碍指标以及脑震荡后症状之间似乎存在关联。S-100B 与神经心理学表现指标之间似乎没有关联。
初始评估时 S-100B 水平高（>2.5μg/L）的患者可能是头部创伤后出现功能障碍的高危人群。
