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血清S-100β蛋白作为急性苯丙胺中毒心脏毒性和临床不良预后预测指标的潜在作用

Potential Role of Serum S-100β Protein as a Predictor of Cardiotoxicity and Clinical Poor Outcome in Acute Amphetamine Intoxication.

作者信息

Sharif Asmaa F, Elsheikh Eman, Al-Asmari Abdullah Z, Gameel Dina El

机构信息

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Clinical Sciences Departement, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia.

出版信息

Cardiovasc Toxicol. 2021 May;21(5):375-386. doi: 10.1007/s12012-020-09630-1. Epub 2021 Jan 9.

DOI:10.1007/s12012-020-09630-1
PMID:33423174
Abstract

Cardio- and neurotoxicity of amphetamines play an important role in worsening morbidity, making the initial evaluation of the patient's status a potentially lifesaving action. The current study hypothesized that the S-100β serum level could predict the severity of acute amphetamine toxicity and the in-hospital outcome. The current study is a prospective cohort study conducted on 77 patients diagnosed with acute amphetamine exposure and referred to Aseer Poison Control Center, Saudi Arabia. The patients admitted to ICU showed significantly higher serum levels of S-100β in comparison to those not admitted (p < 0.05). Moreover, the S-100β level was significantly elevated among patients with prolonged QTc intervals. Receiver-operating characteristic curve of S-100β serum level as an in-hospital outcome predictor showed that at a cutoff value > 0.430 ug/L, the sensitivity of S-100β serum level as severity predictor was 100%, and the specificity was 74.1%. In conclusion, the current study revealed that the S-100β serum level could be used as an outcome predictor in hospital admission cases due to toxic amphetamine exposure and offers an idea about the cardiac and neuronal involvement. This can help select patients who will benefit most from ICU admission and early management and assess the severity of cases in settings where GC-MS is not available.

摘要

苯丙胺的心脏毒性和神经毒性在病情恶化中起重要作用,因此对患者状况进行初步评估可能是一项挽救生命的措施。本研究假设,S-100β血清水平可预测急性苯丙胺中毒的严重程度及住院结局。本研究是一项前瞻性队列研究,对77例被诊断为急性苯丙胺暴露并转诊至沙特阿拉伯阿西尔中毒控制中心的患者进行。与未入住重症监护病房(ICU)的患者相比,入住ICU的患者血清S-100β水平显著更高(p<0.05)。此外,QTc间期延长的患者中S-100β水平显著升高。作为住院结局预测指标的S-100β血清水平的受试者工作特征曲线显示,在临界值>0.430μg/L时,S-100β血清水平作为严重程度预测指标的敏感性为100%,特异性为74.1%。总之,本研究表明,S-100β血清水平可作为因苯丙胺中毒而住院病例的结局预测指标,并可提示心脏和神经受累情况。这有助于选择最能从入住ICU和早期治疗中获益的患者,并在无法进行气相色谱-质谱联用(GC-MS)检测的情况下评估病例的严重程度。

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