Krzych Łukasz J, Czempik Piotr Filip, Saucha Wojciech, Kokocińska Danuta, Knapik Piotr
Clinical Department of Cardiac Anesthesia and Intensive Care, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
Anaesthesiol Intensive Ther. 2015;47(4):320-3. doi: 10.5603/AIT.2015.0041.
Protein S100B is considered to be a marker of brain damage, but there is a paucity of data regarding the utility of its assessment in brain-dead organ donors. The aim of the study was to compare serum protein S100B concentrations between brain-dead organ donors and patients with a confirmed permanent neurological deficit but without signs of brain death.
The concentration of serum S100B protein was measured in 12 brain-dead organ donors (including 7 males with a median age of 40 years). All measurements were taken when brain death was confirmed by the commission. Twenty-nine patients (including 13 males with a median age of 63 years) who died in the medical ICU with confirmed permanent brain injury without signs of brain death acted as controls. In these patients, S-100B protein measurements were performed upon ICU admission.
In brain-dead organ donors, the median values of serum S100B protein were much higher in comparison to the control group (median and IQR, respectively: 5.04 μg L⁻¹; 1.775-6.765 vs 0.897 μg L⁻¹; 0.324-1.880, P < 0.001). S100B serum values > 1.81 μg L⁻¹ predicted brain death with the highest accuracy (AUROC = 0.83; 95% CI 0.68-0.93; P < 0.001).
Concentrations of serum S100B protein in brain-dead organ donors are extremely high and may support the diagnosis of brain death. This fact may be of value when the presence of reflex movements (frequently reported despite brain death) might delay determination of brain death and result in the failure of organ donation.
蛋白S100B被认为是脑损伤的标志物，但关于其在脑死亡器官捐献者中评估效用的数据匮乏。本研究的目的是比较脑死亡器官捐献者与确诊为永久性神经功能缺损但无脑死亡迹象的患者之间血清蛋白S100B的浓度。
对12名脑死亡器官捐献者（包括7名男性，中位年龄40岁）的血清S100B蛋白浓度进行了测量。所有测量均在委员会确认脑死亡时进行。29名在医疗重症监护病房死亡、确诊为永久性脑损伤且无脑死亡迹象的患者（包括13名男性，中位年龄63岁）作为对照。在这些患者中，入院时进行了S-100B蛋白测量。
与对照组相比，脑死亡器官捐献者血清S100B蛋白的中位值要高得多（中位数和四分位距分别为：5.04 μg L⁻¹；1.775 - 6.765 vs 0.897 μg L⁻¹；0.324 - 1.880，P < 0.001）。血清S100B值>1.81 μg L⁻¹预测脑死亡的准确性最高（曲线下面积 = 0.83；95%可信区间0.68 - 0.93；P < 0.001）。
脑死亡器官捐献者血清S100B蛋白浓度极高，可能有助于脑死亡的诊断。当存在反射运动（尽管脑死亡仍经常报告）可能会延迟脑死亡的判定并导致器官捐献失败时，这一事实可能具有重要意义。
