Department of Neurology, Kitasato University School of Medicine, Kanagawa 252-0374, Japan.
Am J Emerg Med. 2012 Jan;30(1):222-5. doi: 10.1016/j.ajem.2010.11.025. Epub 2010 Dec 24.
S100B is a calcium-binding protein produced by astroglia in the brain and has been used as a marker of neuronal damage after brain trauma. We investigated the utility of S100B in cerebrospinal fluid (CSF) measured during the early phase of carbon monoxide (CO) poisoning in predicting the subsequent clinical course.
The study included 31 patients who were admitted to the hospital with loss of consciousness following CO poisoning. S100B levels were measured by enzyme-linked immunosorbent assay in CSF, and serum samples collected simultaneously within 24 hours and on the fourth day after CO exposure. All patients were followed for at least 3 months and divided into 3 groups based on the clinical course: persistent vegetative state (PVS), delayed encephalopathy (DE), and complete recovery with no complications (NC).
During the 3-month period, 3 patients developed PVS, 5 developed DE, and 23 were classified as NC. The mean S100B levels in the CSF within 24 hours after CO exposure were higher in the PVS group (9.25 ng/mL) than in the DE (2.03 ng/mL) and NC groups (1.86 ng/mL). However, the mean serum S100B levels were not elevated in the 3 groups (0.21, 0.59, and 0.16 ng/mL, respectively).
Early elevation of S100B in CSF after CO poisoning could be a suitable predictor of subsequent development of PVS.
S100B 是一种在大脑中星形胶质细胞产生的钙结合蛋白，已被用作脑外伤后神经元损伤的标志物。我们研究了 S100B 在一氧化碳（CO）中毒早期脑脊液（CSF）中的应用，以预测随后的临床病程。
本研究纳入了 31 例因 CO 中毒导致意识丧失而住院的患者。通过酶联免疫吸附试验测定 CSF 中的 S100B 水平，并在 CO 暴露后 24 小时内和第 4 天同时采集血清样本。所有患者均随访至少 3 个月，并根据临床病程分为 3 组：持续性植物状态（PVS）、迟发性脑病（DE）和无并发症完全恢复（NC）。
在 3 个月期间，3 例患者发展为 PVS，5 例患者发展为 DE，23 例患者被归类为 NC。CO 暴露后 24 小时内 CSF 中 S100B 的平均水平在 PVS 组（9.25ng/mL）高于 DE 组（2.03ng/mL）和 NC 组（1.86ng/mL）。然而，3 组血清 S100B 水平均未升高（分别为 0.21、0.59 和 0.16ng/mL）。
CO 中毒后 CSF 中 S100B 的早期升高可能是预测随后发生 PVS 的合适指标。
