S100B 可预测心脏手术后儿童的神经功能缺损。
Neurological deficit is predicted by S100B in children after cardiac surgery.
机构信息
Pediatric Neurology Unit and Talpiot Medical Leadership Program, Edmond and Lili Safra Children's Hospital, Chaim Sheba Medical Center affiliated with the Sackler School of Medicine, Tel-Aviv University, Ramat Gan 5262100, Israel; Edmond and Lili Safra Children's Hospital, Tel-Aviv University, Ramat Gan 5262100, Israel; Chaim Sheba Medical Center affiliated with Sackler School of Medicine, Tel-Aviv University, Ramat Gan, Israel.
Edmond and Lili Safra Children's Hospital, Tel-Aviv University, Ramat Gan 5262100, Israel; Chaim Sheba Medical Center affiliated with Sackler School of Medicine, Tel-Aviv University, Ramat Gan, Israel.
出版信息
Clin Chim Acta. 2018 Jun;481:56-60. doi: 10.1016/j.cca.2018.02.032. Epub 2018 Feb 27.
INTRODUCTION
Children undergoing cardiac surgery may suffer from brain injuries after surgery and develop neurological deficit. Early diagnosis of brain injury after surgery would enable early therapeutic interventions. The aim of the study is to test whether S100B can serve as a biomarker for brain injury after cardiac surgery.
METHODS
Seventy-five patients were enrolled in the study. Serum S100B was collected at the beginning of the surgery, and 6, 12, 24 h after surgery. S100B z-scores were calculated based on norms for age. Neurological evolutions were done before surgery and at discharge by the Pediatric Stroke Outcome Measure (PSOM). New neurological deficit (NND) was defined as a 1 point increase on the PSOM scale.
RESULTS
Twenty patients had an NND after cardiac surgery. Medical background was similar between the groups with and without NND. S100B z-scores were significantly higher in the NND group at all time points after surgery. Using a cut-off of 3 z-score at 6 h after surgery, the positive predictive value was 79% and the negative predictive value was 90%.
CONCLUSIONS
S100B is a potent early biomarker for brain injury after cardiac surgery. Hopefully, S100B could be used to prevent progression of brain injuries after cardiac surgery.
简介
接受心脏手术的儿童术后可能会遭受脑损伤并出现神经功能缺损。早期诊断术后脑损伤可以进行早期治疗干预。本研究旨在验证 S100B 是否可作为心脏手术后脑损伤的生物标志物。
方法
共纳入 75 名患者。在手术开始时、手术后 6、12、24 小时采集血清 S100B。根据年龄正常值计算 S100B z 分数。在术前和出院时使用儿科中风结局量表（PSOM）评估神经功能演变。新的神经功能缺损（NND）定义为 PSOM 评分增加 1 分。
结果
20 名患者在心脏手术后出现 NND。有和无 NND 组的医疗背景相似。在术后所有时间点，NND 组的 S100B z 分数明显更高。在术后 6 小时使用 3 z 分数的截断值，阳性预测值为 79%，阴性预测值为 90%。
结论
S100B 是心脏手术后脑损伤的有效早期生物标志物。希望 S100B 可用于预防心脏手术后脑损伤的进展。
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