Bloomfield Stephen M, McKinney James, Smith Les, Brisman Jonathan
New Jersey Neuroscience, Institute JFK Hospital and Medical Center, Edison, NJ 08818, USA.
Neurocrit Care. 2007;6(2):121-38. doi: 10.1007/s12028-007-0008-x.
S100B is a protein biomarker that reflects CNS injury. It can be measured in the CSF or serum with readily available immunoassay kits. The excellent sensitivity of S100B has enabled it to confirm the existence of subtle brain injury in patients with mild head trauma, strokes, and after successful resuscitation from cardiopulmonary arrest. The extent of S100B elevation has been found to be useful in predicting clinical outcome after brain injury. Elevations of S100B above certain threshold levels might be able to reliably predict brain death or mortality. A normal S100B level reliably predicts the absence of significant CNS injury. The specificity of S100B levels as a reflection of CNS injury is compromised by the findings that extra-cranial injuries can lead to elevations in the absence of brain injury. This potential problem can most likely be avoided by measuring serial S100B levels along with other biomarkers and carefully noting peripheral injuries. Serum markers GFAP and NSE are both more specific for CNS injury and have little to no extra-cranial sources. Sustained elevations of S100B over 24 h along with elevations of GFAP and NSE can more reliably predict the extent of brain injury and clinical outcomes. In the future, S100B measurements might reliably predict secondary brain injury and enable physicians to initiate therapeutic interventions in a timelier manner. S100B levels have been shown to rise hours to days before changes in ICP, neurological examinations, and neuroimaging tests. S100B levels may also be used to monitor the efficacy of treatments.
S100B是一种反映中枢神经系统（CNS）损伤的蛋白质生物标志物。使用现成的免疫分析试剂盒即可在脑脊液或血清中对其进行检测。S100B具有出色的敏感性，能够证实轻度头部创伤、中风患者以及心肺骤停成功复苏后存在细微的脑损伤。已发现S100B升高的程度有助于预测脑损伤后的临床结局。S100B升高超过特定阈值水平可能能够可靠地预测脑死亡或死亡率。S100B水平正常可可靠地预测不存在显著的中枢神经系统损伤。由于颅外损伤可在无脑损伤的情况下导致S100B水平升高，因此S100B水平反映中枢神经系统损伤的特异性受到影响。通过测量S100B的系列水平并结合其他生物标志物，并仔细记录外周损伤，很可能可以避免这一潜在问题。血清标志物胶质纤维酸性蛋白（GFAP）和神经元特异性烯醇化酶（NSE）对中枢神经系统损伤的特异性更高，且几乎没有颅外来源。S100B持续升高超过24小时，同时伴有GFAP和NSE升高，能够更可靠地预测脑损伤的程度和临床结局。未来，S100B检测可能能够可靠地预测继发性脑损伤，并使医生能够更及时地启动治疗干预措施。已表明S100B水平在颅内压（ICP）、神经学检查和神经影像学检查出现变化前数小时至数天就会升高。S100B水平还可用于监测治疗效果。
