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S100B 血清生物标志物在治疗儿童轻度创伤性脑损伤中的作用。

Role of the S100B serum biomarker in the treatment of children suffering from mild traumatic brain injury.

机构信息

Department of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Greece

出版信息

Neurosurg Focus. 2010 Nov;29(5):E2. doi: 10.3171/2010.8.FOCUS10185.

Abstract

OBJECT

The aim of this study was to provide a systematic update of the current literature regarding the clinical role of the S100B serum biomarker in the initial evaluation of children who have sustained a mild traumatic brain injury (TBI).

METHODS

Searches in MEDLINE were defined with the keywords "mild TBI children S100," "mild TBI pediatric S100," and "children S100 brain injury." From the pool of obtained studies, those that had the inclusion criteria of mild TBI only or mixed types of TBI but including detailed information about groups of children with mild TBI were used.

RESULTS

Few studies were identified and fewer included more than 100 cases. The prospective studies showed that the S100B biomarker levels could be influenced by patient age and the time frame between head injury and blood sampling. Moreover, extracranial sources of S100B or additional injuries could influence the measured levels of this biomarker. A normal value of S100B in children with mild TBI could rule out injury-associated abnormalities on CT scans in the majority of reported cases.

CONCLUSIONS

The vulnerability of S100B serum levels to the influences of patient age, blood sampling time, and extracranial S100B release limits the biomarker's role in the initial evaluation of children with mild TBI. The application of S100B in pediatric mild TBI cases has an elusive role, although it could help in selected cases to avoid unnecessary head CT scans.

摘要

目的

本研究旨在对目前关于 S100B 血清生物标志物在评估轻度创伤性脑损伤(TBI)患儿中的临床作用的文献进行系统更新。

方法

在 MEDLINE 中使用关键词“儿童轻度 TBI S100”、“儿科轻度 TBI S100”和“儿童 S100 脑损伤”进行搜索。从获得的研究中,选择仅包括轻度 TBI 或混合类型 TBI 但包括详细的轻度 TBI 患儿分组信息的研究。

结果

确定的研究很少,纳入的研究中超过 100 例的研究更少。前瞻性研究表明,S100B 生物标志物水平可能受到患者年龄和头部受伤与采血时间之间时间框架的影响。此外,S100B 的颅外来源或其他损伤可能会影响该生物标志物的测量水平。大多数报告的病例中,轻度 TBI 患儿的 S100B 正常值可以排除 CT 扫描上与损伤相关的异常。

结论

S100B 血清水平易受患者年龄、采血时间和颅外 S100B 释放的影响,限制了该生物标志物在轻度 TBI 患儿初始评估中的作用。尽管 S100B 在儿科轻度 TBI 病例中的应用作用尚不明确,但它可以帮助在某些情况下避免不必要的头部 CT 扫描。

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