Egea-Guerrero J J, Revuelto-Rey J, Murillo-Cabezas F, Muñoz-Sánchez M A, Vilches-Arenas A, Sánchez-Linares P, Domínguez-Roldán J M, León-Carrión J
NeuroCritical Care Unit, Virgen del Rocío University Hospital, Seville, Spain.
Brain Inj. 2012;26(1):76-82. doi: 10.3109/02699052.2011.635360.
This study tested the hypothesis that S100β is a useful screening tool for detecting intracranial lesion (IL) in patients with a normal level of consciousness after traumatic brain injury (TBI).
One hundred and forty-three post-TBI patients without a decrease in consciousness (GCS = 15) and with at least one neurological symptom (e.g. transitory loss of consciousness, amnesia, headache, dizziness or vomiting) were prospectively included. A blood sample was drawn at 6-hours post-TBI. A routine CT scan was obtained within 24 hours post-injury. Diagnostic properties of S100β for IL prediction in CT scan findings were tested using ROC-analysis.
A total of 15 patients (10.5%) had IL. Serum levels were significantly higher in these patients. Significant differences were found between S100β levels and CT scan findings (p = 0.007). ROC-analysis showed that S100β is a useful tool for detecting the presence of IL in CT scans (p = 0.007). In this series, the best cut-off for S100β is 0.130 µg L(-1), with 100% sensitivity and 32.81% specificity.
Within the first 6 hours post-TBI, serum S100β seems to be an effective biochemical indicator of IL in patients without a decrease in consciousness. These results indicate that higher S100β cut-off values substantially improve the clinical relevance of this protein.
本研究检验了以下假设，即S100β是检测创伤性脑损伤（TBI）后意识水平正常患者颅内病变（IL）的有用筛查工具。
前瞻性纳入143例TBI后意识未减退（格拉斯哥昏迷量表[GCS]=15）且至少有一项神经症状（如短暂意识丧失、失忆、头痛、头晕或呕吐）的患者。在TBI后6小时采集血样。伤后24小时内进行常规CT扫描。使用ROC分析测试S100β在CT扫描结果中预测IL的诊断特性。
共有15例患者（10.5%）存在IL。这些患者的血清水平显著更高。S100β水平与CT扫描结果之间存在显著差异（p=0.007）。ROC分析表明，S100β是检测CT扫描中IL存在情况的有用工具（p=0.007）。在本系列中，S100β的最佳截断值为0.130µg L⁻¹，敏感性为100%，特异性为32.81%。
在TBI后的最初6小时内，血清S100β似乎是意识未减退患者IL的有效生化指标。这些结果表明，更高的S100β截断值可显著提高该蛋白的临床相关性。
