S100B在一组西班牙轻度创伤性脑损伤患者中的应用验证：一项多中心研究。
Validation of S100B use in a cohort of Spanish patients with mild traumatic brain injury: a multicentre study.
作者信息
Egea-Guerrero Juan José, Rodríguez-Rodríguez Ana, Quintana-Díaz Manuel, Freire-Aragón María Dolores, Raya-Collados Diego, Hernández-García Conary, Ortiz-Manzano Álvaro, Vilches-Arenas Ángel, Díez-Naz Ana, Guerrero Juan Miguel, Murillo-Cabezas Francisco
机构信息
a NeuroCritical Care Unit , Virgen del Rocío University Hospital, IBIS/CSIC/University of Seville , Seville , Spain.
b Emergency Department , Virgen del Rocío University Hospital, IBIS/CSIC/University of Seville , Seville , Spain.
出版信息
Brain Inj. 2018;32(4):459-463. doi: 10.1080/02699052.2018.1429019. Epub 2018 Jan 22.
INTRODUCTION
The aim of this study was to validate the S100B protein as a diagnostic tool for ruling out the presence of intracranial lesion (IL) after mild traumatic brain injury (mTBI). Subjects with a Glasgow Coma Scale (GCS) score of 15 and at least one neurological symptom post-trauma were selected from a large Spanish cohort.
METHODS
A number of 260 patients with mTBI were enrolled. Blood samples were extracted within 6 h and CT scan performed within 24 h post-injury. Blood samples were also drawn from 18 healthy subjects.
RESULTS
CT scan revealed the presence of IL in 22 patients (8.5%). Patients with mTBI had higher S100B serum levels (p = 0.008) than the healthy subjects (p < 0.001). The ROC analysis of S100B discriminated between patients with and without IL (AUC: 0.671; 95%CI: 0.574-0.769; p = 0.008). The multivariate analysis identified male gender (OR: 5.39; 95%CI: 1.45-20.10; p = 0.012), age > 65 (OR: 2.97; 95%CI: 1.04-8.44; p = 0.041) and S100B level >0.10 µg/L (OR: 7.93; 95%CI: 1.03-60.76; p = 0.046) as independent risk factors for IL in patients with mTBI.
CONCLUSION
Measurement of S100B within 6 h of mTBI accurately predicts risk of IL in patients with a GCS score of 15 and at least one neurological symptom.
引言
本研究的目的是验证S100B蛋白作为排除轻度创伤性脑损伤（mTBI）后颅内病变（IL）存在的诊断工具。从一个大型西班牙队列中选取格拉斯哥昏迷量表（GCS）评分为15且创伤后至少有一项神经症状的受试者。
方法
纳入260例mTBI患者。受伤后6小时内采集血样，24小时内进行CT扫描。还从18名健康受试者中采集血样。
结果
CT扫描显示22例患者（8.5%）存在IL。mTBI患者的S100B血清水平高于健康受试者（p = 0.008）（p < 0.001）。S100B的ROC分析区分了有IL和无IL的患者（AUC：0.671；95%CI：0.574 - 0.769；p = 0.008）。多变量分析确定男性（OR：5.39；95%CI：1.45 - 20.10；p = 0.012）、年龄>65岁（OR：2.97；95%CI：1.04 - 8.44；p = 0.041）和S100B水平>0.10μg/L（OR：7.93；95%CI：1.03 - 60.76；p = 0.046）是mTBI患者发生IL的独立危险因素。
结论
mTBI后6小时内测量S100B可准确预测GCS评分为15且至少有一项神经症状的患者发生IL的风险。
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