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血清 S100B 蛋白在预测急性一氧化碳中毒迟发性神经后遗症中的作用。

The usefulness of the serum s100b protein for predicting delayed neurological sequelae in acute carbon monoxide poisoning.

机构信息

Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.

出版信息

Clin Toxicol (Phila). 2012 Mar;50(3):183-8. doi: 10.3109/15563650.2012.658918.

Abstract

CONTEXT

Some patients with acute carbon monoxide poisoning will experience delayed neurological sequelae. Several factors associated with delayed neurological sequelae have been reported, but these factors are unsatisfactory for the assessment of unconscious patients.

OBJECTIVE

The aim of this study was to assess the usefulness of the serum S100B protein as a biochemical marker for predicting delayed neurological sequelae.

MATERIALS AND METHODS

In this retrospective study, we evaluated the data for patients who visited an emergency medical center once during a period of 7 months. The enrollment criteria were the diagnosis of acute carbon monoxide poisoning and the measurement of the serum S100B level. A standardized extraction using medical records was performed.

RESULT

A total of 71 patients were enrolled, and 10 patients (14.1%) presented delayed neurological sequelae. The delayed neurological sequelae group had a longer duration of carbon monoxide exposure, a longer duration of loss of consciousness, and a worse mental status (p-value < 0.001). In addition, the S100B protein levels were higher in the delayed neurological sequelae group (0.891 vs. 0.063, p-value < 0.001). Multiple logistic regression analysis showed that only the serum S100B protein level was independently associated with the development of delayed neurological sequelae (OR, 120.594; 95% CI, 4.194-3467.220), and a serum S100B protein level of more than 0.165 μg/L predicted the development of delayed neurological sequelae (sensitivity 90%, specificity 87%).

DISCUSSION AND CONCLUSION

In the present study, the level of serum S100B protein was found to be useful for evaluating acute CO poisoning patients and was found to be an independent predictor of the development of DNS after acute CO poisoning.

摘要

背景

一些急性一氧化碳中毒患者会出现迟发性神经后遗症。已经报道了与迟发性神经后遗症相关的几个因素,但这些因素对于评估无意识患者并不理想。

目的

本研究旨在评估血清 S100B 蛋白作为预测迟发性神经后遗症的生化标志物的有用性。

材料和方法

在这项回顾性研究中,我们评估了在 7 个月期间到急诊医学中心就诊的患者的数据。入选标准为急性一氧化碳中毒的诊断和血清 S100B 水平的测量。使用病历进行了标准化提取。

结果

共纳入 71 例患者,其中 10 例(14.1%)出现迟发性神经后遗症。迟发性神经后遗症组的一氧化碳暴露时间更长,意识丧失时间更长,精神状态更差(p 值<0.001)。此外,迟发性神经后遗症组的 S100B 蛋白水平更高(0.891 比 0.063,p 值<0.001)。多变量逻辑回归分析表明,只有血清 S100B 蛋白水平与迟发性神经后遗症的发生独立相关(OR,120.594;95%CI,4.194-3467.220),血清 S100B 蛋白水平超过 0.165μg/L 可预测迟发性神经后遗症的发生(敏感性 90%,特异性 87%)。

讨论和结论

在本研究中,发现血清 S100B 蛋白水平有助于评估急性 CO 中毒患者,并且是急性 CO 中毒后发生 DNS 的独立预测因子。

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