[血清S100B和NSE水平检测在体外循环术后早期脑损伤诊断中的临床价值]

[Clinical values of detection of serum levels of S100B and NSE in diagnosis of brain injuries at early period after cardiopulmonary bypass].

作者信息

Gu Xing-hua, Zhang Gong, Zhang Xi-quan, Song Yi, Wang Tao, Li Shou-xian

机构信息

Department of Cardiac Surgery, Qilu Hospital of Shandong University, Jinan 250012, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 Apr 10;87(14):975-7.

PMID:17650423

Abstract

OBJECTIVE

To investigate the clinical values of detecting the blood serum levels of S100B and neuron-specific enolase (NSE) in diagnosis of brain injuries at early period after cardiopulmonary bypass (CPB).

METHODS

Forty-eight patients with heart disease were divided into 2 groups: CPB group (n = 40) and off-CPB group (n = 8). Before operation, and 24 hours and 48 hours after CPB specimens of peripheral blood were collected and ELISA was used to detect the serum levels of S100B and NSE. Forty-eight hours after the operation brain damage quotient (DQ) was calculated.

RESULTS

The serum levels of S100B 24 and 48 hours after operation of the CPB group were 0.61 microg/L +/- 0.18 microg/L and 0.37 microg/L +/- 0.12 microg/L respectively, both significantly higher than that before the operation (0.05 microg/L +/- 0.03 microg/L, P < 0.001). The serum levels of NSE 24 and 48 hours after operation of the CPB group were 10.14 microg/L +/- 3.87 microg/L and 5.77microg/L +/- 2.31 microg/L respectively, both significantly higher than that before operation (2.98 microg/L +/- 1.49 microg/L, P < 0.001). The serum levels of S100B 24 and 48 hours after operation of the off-CPB group were 0.05 microg/L +/- 0.03 microg/L and 0.04 microg/L +/- 0.03 microg/L respectively, both not significantly different from that before operation (0.04 microg/L +/- 0.03 microg/L, P > 0.05). The serum levels of NSE 24 and 48 hours after operation of the off-CPB group were 2.91 microg/L +/- 1.56 microg/L and 2.87 microg/L +/- 1.41 microg/L respectively, both not significantly different from that before operation (2.76 microg/L +/- 1.23 microg/L, P > 0.05). The levels of S100B and NSE 24 hours after CPB were positively correlated with age, CPB time, and cross-clamp time (all P < 0.05). The levels of S100B and NSE 48 hours after CPB were positively correlated with the brain DQ (r = 0.739 P < 0.01, r = 0.371 P < 0.05). The multiple correlation coefficient square (R2) of detection of the levels of both S100B and NSE was 0.851, significantly higher than that of mere detection of S100B (R2 = 0.703) and that of mere detection of NSE (R2 = 0.482) (both P < 0.01).

CONCLUSION

Both serum S100B and serum NSE are sensitive markers in the early diagnosis of brain injuries after CPB. Detection of both S100B and NSE is the most specific, and mere detection of S100B comes behind.

摘要

目的

探讨检测血清S100B和神经元特异性烯醇化酶（NSE）水平在体外循环（CPB）后早期脑损伤诊断中的临床价值。

方法

将48例心脏病患者分为2组：CPB组（n = 40）和非CPB组（n = 8）。术前、CPB后24小时和48小时采集外周血标本，采用酶联免疫吸附测定（ELISA）法检测血清S100B和NSE水平。术后48小时计算脑损伤商数（DQ）。

结果

CPB组术后24小时和48小时血清S100B水平分别为0.61μg/L±0.18μg/L和0.37μg/L±0.12μg/L，均显著高于术前（0.05μg/L±0.03μg/L，P < 0.001）。CPB组术后24小时和48小时血清NSE水平分别为10.14μg/L±3.87μg/L和5.77μg/L±2.31μg/L，均显著高于术前（2.98μg/L±1.49μg/L，P < 0.001）。非CPB组术后24小时和48小时血清S100B水平分别为0.05μg/L±0.03μg/L和0.04μg/L±0.03μg/L，与术前（0.04μg/L±0.03μg/L）相比差异均无统计学意义（P > 0.05）。非CPB组术后24小时和48小时血清NSE水平分别为2.91μg/L±1.56μg/L和2.87μg/L±1.41μg/L，与术前（2.76μg/L±1.23μg/L）相比差异均无统计学意义（P > 0.05）。CPB后24小时S100B和NSE水平与年龄、CPB时间和主动脉阻断时间均呈正相关（均P < 0.05）。CPB后48小时S100B和NSE水平与脑DQ呈正相关（r = 0.739，P < 0.01；r = 0.371，P < 0.05）。S100B和NSE水平联合检测的复相关系数平方（R2）为0.851，显著高于单独检测S100B（R2 = 0.703）和单独检测NSE（R2 = 0.482）（均P < 0.01）。