Department of Biochemistry and Molecular Biology, CHU Clermont-Ferrand, Clermont-Ferrand, France.
EA7281-Retinoids, Reproduction Developmental Diseases, School of Medicine, Clermont Université, Université d'Auvergne, Clermont-Ferrand, France.
Sports Med. 2017 Apr;47(4):781-789. doi: 10.1007/s40279-016-0579-9.
The incidence of concussion in professional direct-contact sports, particularly in rugby, has increased in recent years. To date, cognitive assessment is the most common means of determining whether a concussed player can return to the game. Serum S100B assay, an objective blood test known to be useful in brain injury management, may offer a novel additional approach to the management of concussed male rugby players.
The aim of this study was to investigate the S100B utility for the determination of concussion in a professional 15-players-a-side rugby team.
Thirty-nine male rugby players were included in a prospective study during the 2014-2015 French championship season. Serum sampling was carried out several times at baseline and after a match and/or a concussion, at set times (2, 36 h). Serum S100B concentrations were determined using chemiluminescence immunoassay on a Roche Diagnostics instrument.
The players' basal serum S100B was stable during the season and was not correlated with anthropometric data, body composition, or creatine kinase concentration. A significant increase in S100B concentration within 2 h after a game (without concussion) was observed. This increase was correlated with the number of body collisions during a match. Seventy-seven assays were performed 36 h after a game, including the follow-up of five concussed players. Thirty-six hours after a match, an increase of a minimum of 20 % compared with individual basal concentrations identified concussion with 100 % sensitivity and 81 % specificity.
S100B measured 36 h after a match is thus a discriminating test to identify concussion in a male rugby player, with a 100 % negative predictive value.
近年来,专业直接接触性运动(尤其是橄榄球)中的脑震荡发生率有所增加。迄今为止,认知评估是确定脑震荡运动员是否能重返赛场的最常用方法。血清 S100B 测定,一种已知对脑损伤管理有用的客观血液检测方法,可能为管理脑震荡男性橄榄球运动员提供一种新的方法。
本研究旨在探讨 S100B 在确定 15 人制职业橄榄球队脑震荡中的应用。
39 名男性橄榄球运动员参加了 2014-2015 年法国锦标赛赛季的前瞻性研究。在基线和比赛后(和/或脑震荡后)的设定时间(2、36 小时)多次进行血清取样。使用罗氏诊断仪器上的化学发光免疫测定法测定血清 S100B 浓度。
运动员的基础血清 S100B 在整个赛季保持稳定,与人体测量数据、身体成分或肌酸激酶浓度无关。在没有脑震荡的情况下,比赛后 2 小时内 S100B 浓度显著升高。这种增加与比赛中的身体碰撞次数有关。在比赛后 36 小时进行了 77 次检测,包括对 5 名脑震荡患者的随访。比赛后 36 小时,与个体基础浓度相比,增加至少 20%可识别脑震荡,具有 100%的敏感性和 81%的特异性。
因此,比赛后 36 小时测量的 S100B 是一种区分男性橄榄球运动员脑震荡的检测方法,具有 100%的阴性预测值。