Rodríguez-Rodríguez Ana, Egea-Guerrero Juan José, Gordillo-Escobar Elena, Enamorado-Enamorado Judy, Hernández-García Conary, Ruiz de Azúa-López Zaida, Vilches-Arenas Ángel, Guerrero Juan Miguel, Murillo-Cabezas Francisco
a NeuroCritical Care Unit , Virgen del Rocío University Hospital, IBIS/CSIC/University of Seville , Seville , Spain.
b Department of Clinical Biochemistry , Virgen del Rocio University Hospital, IBIS/CSIC/University of Seville , Seville , Spain.
Neurol Res. 2016 Feb;38(2):130-7. doi: 10.1080/01616412.2016.1144410. Epub 2016 Mar 4.
To determine temporal profile and prognostic ability of S100B protein and neuron-specific enolase (NSE) for prediction of short/long-term mortality in patients suffering from severe traumatic brain injury (sTBI).
Ninety-nine patients with sTBI were included in the study. Blood samples were drawn on admission and on subsequent 24, 48, 72, and 96 h.
15.2% of patients died in NeuroCritical Care Unit, and 19.2% died within 6 months of the accident. S100B concentrations were significantly higher in patients who died compared to survivors. NSE levels were different between groups just at 48 h. In the survival group, S100B levels decreased from 1st to 5th sample (p < 0.001); NSE just from 1st to 3rd (p < 0.001) and then stabilized. Values of S100B and NSE in non-survival patients did not significantly vary over the four days post sTBI. ROC-analysis showed that all S100B samples were useful tools for predicting mortality, the best the 72 h sample (AUC 0.848 for discharge mortality, 0.855 for six-month mortality). NSE ROC-analysis indicated that just the 48-h sample predicted mortality (AUC 0.733 for discharge mortality, 0.720 for six-month mortality).
S100B protein showed higher prognostic capacity than NSE to predict short/long-term mortality in sTBI patients.
确定S100B蛋白和神经元特异性烯醇化酶（NSE）的时间变化情况及其预测重型颅脑损伤（sTBI）患者短期/长期死亡率的预后能力。
99例sTBI患者纳入本研究。入院时及随后的24、48、72和96小时采集血样。
15.2%的患者在神经重症监护病房死亡，19.2%的患者在事故后6个月内死亡。与幸存者相比，死亡患者的S100B浓度显著更高。仅在48小时时两组间NSE水平存在差异。在存活组中，S100B水平从第1次到第5次采样时下降（p<0.001）；NSE仅从第1次到第3次采样时下降（p<0.001），然后趋于稳定。非存活患者的S100B和NSE值在sTBI后的四天内无显著变化。ROC分析表明，所有S100B样本都是预测死亡率的有用工具，72小时样本最佳（出院死亡率的AUC为0.848，6个月死亡率的AUC为0.855）。NSE的ROC分析表明，仅48小时样本可预测死亡率（出院死亡率的AUC为0.733，6个月死亡率的AUC为0.720）。
在预测sTBI患者的短期/长期死亡率方面，S100B蛋白比NSE具有更高的预后能力。
