Neonatal Intensive Care Unit, G. d'Annunzio University, Chieti, Italy.
Department of Neonatology, Neonatal Intensive Care Unit, Bambino Gesù; Children's Hospital, Rome, Italy.
Clin Chem Lab Med. 2021 May 19;59(9):1527-1534. doi: 10.1515/cclm-2021-0278. Print 2021 Aug 26.
The early detection of preterm infants (PI) at risk for intraventricular hemorrhage (IVH) and neurological sequelae still constitutes an unsolved issue. We aimed at validating the role of S100B protein in the early diagnosis and prognosis of IVH in PI by means of cerebral ultrasound (CUS) and magnetic resonance imaging (MRI) today considered standard of care procedures.
We conducted an observational case-control study in 216 PI of whom 36 with IVH and 180 controls. Standard clinical, laboratory, radiological monitoring procedures and S100B urine measurement were performed at four time-points (first void, 24, 48, 96 h) after birth. Cerebral MRI was performed at 40-42 weeks of corrected gestational age.
Elevated (p<0.001, for all) S100B levels were observed in the IVH group at all monitoring time-point particularly at first void when standard monitoring procedures were still silent or unavailable. S100B measured at first void correlated (p<0.001) with the grade of hemorrhage by means of CUS and with the site and extension of neurological lesion (p<0.001, for all) as assessed by MRI.
The present results showing a correlation among S100B and CUS and MRI offer additional support to the inclusion of the protein in clinical daily management of cases at risk for IVH and adverse neurological outcome. The findings open the way to further investigations in PI aimed at validating new neurobiomarkers by means of S100B.
早产婴儿（PI）颅内出血（IVH）和神经后遗症的早期检测仍然是一个未解决的问题。我们旨在通过目前被认为是标准护理程序的脑超声（CUS）和磁共振成像（MRI）来验证 S100B 蛋白在 PI 中 IVH 的早期诊断和预后中的作用。
我们进行了一项观察性病例对照研究，共纳入 216 例 PI，其中 36 例有 IVH，180 例为对照组。在出生后四个时间点（首次排尿后、24、48、96 小时）进行标准临床、实验室、影像学监测程序和 S100B 尿测量。在纠正胎龄 40-42 周时进行脑 MRI。
在 IVH 组的所有监测时间点（尤其是首次排尿时），S100B 水平均升高（均为 p<0.001），而在标准监测程序仍未出现或无法获得时，S100B 水平升高。首次排尿时测量的 S100B 与 CUS 评估的出血程度（p<0.001）和 MRI 评估的神经病变部位和程度（p<0.001，均为 p<0.001）相关。
目前的结果表明 S100B 与 CUS 和 MRI 之间存在相关性，为将该蛋白纳入 IVH 风险和不良神经结局病例的临床日常管理提供了额外的支持。这些发现为进一步研究 PI 中 S100B 验证新神经生物标志物铺平了道路。
