Morochovic R, Rácz O, Kitka M, Pingorová S, Cibur P, Tomková D, Lenártová R
Department of Trauma Surgery, School of Medicine, University of P.J.Safárik, Kosice, Slovak Republic.
Eur J Neurol. 2009 Oct;16(10):1112-7. doi: 10.1111/j.1468-1331.2009.02653.x. Epub 2009 May 12.
Neuronal protein S100B assays are available now with a perspective of being an early screening tool for serious intracranial injury. The aim of the study was to correlate early S100B measurements and initial CCT findings in the patients sustaining mild traumatic brain injury (MTBI).
The prospective study included patients of all ages with a history of MTBI. CCT scans and venous blood sampling for S100B analysis were performed within 6 h after injury. Levels of S100B above 0.1 ng/ml (S100B+) and any CCT detectable trauma-relevant intracranial lesions were considered positive (CCT+).
A series of 102 patients were involved in the study. CCT+ scans were present in eighteen (17.6%) and CCT- scans in 84 (82.4%) patients. There were 74 (72.5%) patients in S100B+ and 28 (27.5%) in S100B- group. Sensitivity of S100B assay attained 83.3% with a negative predictive value of 89.3%. Three patients from CCT+ group had negative plasma level of S100B. Two of them required surgical treatment.
S100B serum protein marker seems to be an unrealiable screening tool for determination of an intracranial injury risk group due to low sensitivity and negative predictive value seen from samples taken greater than 3 h after an MTBI.
目前可进行神经元蛋白S100B检测，有望成为严重颅内损伤的早期筛查工具。本研究旨在探讨轻度创伤性脑损伤（MTBI）患者早期S100B检测结果与初次头颅CT（CCT）检查结果之间的相关性。
本前瞻性研究纳入了所有年龄段有MTBI病史的患者。受伤后6小时内进行CCT扫描及采集静脉血样检测S100B。S100B水平高于0.1 ng/ml（S100B+）以及CCT检测到任何与创伤相关的颅内病变均视为阳性（CCT+）。
本研究共纳入102例患者。18例（17.6%）患者CCT扫描结果为阳性（CCT+），84例（82.4%）患者CCT扫描结果为阴性（CCT-）。S100B+组有74例（72.5%）患者，S100B-组有28例（27.5%）患者。S100B检测的灵敏度为83.3%，阴性预测值为89.3%。CCT+组中有3例患者S100B血浆水平为阴性，其中2例需要手术治疗。
由于MTBI后3小时以上采集的样本显示S100B血清蛋白标志物的灵敏度和阴性预测值较低，因此它似乎并非确定颅内损伤风险组的可靠筛查工具。
