重型颅脑损伤患者血清S-100B蛋白含量检测及临床意义

目的 通过检测重型颅脑损伤患者血清S-100B蛋白含量,研究S-100B蛋白含量与重型颅脑损伤严重程度及预后的关系,为预后评估及治疗提供理论依据.方法 选取100例正常体检者为对照组,取其血清标本检测S-100B蛋白含量.选取重型颅脑损伤患者(GCS≤8分)48例,分别于伤后早期(2～6h)及伤后1、3、5、7、10d采血,检测血清中S-100B蛋白含量,比较其在伤后不同时期的血清S-100B蛋白含量.结果 100例正常体检者血清S-100B蛋白含量测定结果 证实,正常人血清S-100B含量与年龄、性别无关.重型颅脑损伤患者伤后血清S-100B蛋白含量与对照组相比有显著性差异(P＜0.01).GCS 3～5分组与GCS 6～8分组患者及不同预后组之间血清S-100B蛋白含量有显著性差异(P＜0.05).结论 S-100B蛋白在诊断重型颅脑损伤及判断严重程度中有高度敏感性和特异性,是一种有效的生化指标,能为预后评估及治疗提供理论依据,值得推广.     

甲基强的松龙对颅脑损伤后血清S-100B蛋白变化的影响

1材料与方法将72只成年SD大鼠随机分为正常组、对照组、治疗组,用3%戊巴比妥30mg/kg腹腔内注射麻醉。正常组8只,只行开颅手术,不作头颅打击;对照组和治疗组各32只,分别分为伤后1h、6h、12h、24h4个小组。对照组和治疗组大鼠麻醉后,采用Feeney法造成鼠脑挫裂伤模型。治疗组大鼠致伤后即刻腹腔内注射30mg/kg甲基强的松龙,对照组则即刻腹腔内注射同等体积生理盐水。对照组和治疗组大鼠分别在伤后1h、6h、12h、24h时间点断头取血3ml,离心后取上清液1ml用ELISA检测技术定量检测血清S-100B蛋白水平。2结果正常组血清S-100B蛋白(0.35±0.029)…     

S-100B蛋白测定在重型颅脑损伤中的临床意义

自1965年Moor等首先在牛脑组织中发现S-100B蛋白并命名以来,随着其分子结构及生物学活性的阐明,目前已成为国内外神经损伤临床研究热点之一[1～11].我们采用双抗体夹心法,对我院自2002年7月至2004年5月收治的36例重型颅脑损伤患者血清S-100B蛋白进行了测定并分析总结如下.     

醒脑注射液对急性重型颅脑损伤患者血清S-100B蛋白浓度的影响

目的 动态观察醒脑注射液对急性重型颅脑损伤患者血清S-100B蛋白浓度的影响,探讨醒脑注射液在急性重型颅脑损伤治疗中的作用.方法 将120例急性重型颅脑损伤患者随机分为醒脑注射液组和常规组各60例.醒脑注射液组在常规治疗的基础上,给醒脑注射液30ml+5%葡萄糖或生理盐水100m1静滴,30min内滴完,1次/d,7d为1个疗程.所有患者于入院6h内和入院后第2、3、4、5、6 天检测血清S-100B蛋白浓度.结果 重型颅脑损伤患者的血清S-100B蛋白浓度明显高于正常对照组(P＜0.05);醒脑注射液组第2～6天血清S-100B蛋自浓度明显低于常规组,差异有显著性(P＜0.05).结论 急性重型颅脑损伤患者血清S-100B蛋白浓度明显升高.醒脑注射液能降低患者血清S-100B蛋白浓度,从而保护神经功能.     

亚低温治疗重型颅脑损伤患者的血清S-100B蛋白含量分析

目的 通过检测亚低温治疗后重型颅脑损伤患者血清S-100B蛋白含量的变化来证实亚低温治疗的脑保护作用,探讨其可能的作用机制.方法 选取100例正常体检者为对照组,选取100例重型颅脑损伤患者(GCS≤8分1并分为亚低温治疗组50例和常温治疗组50例,分别于伤后早期(2～6 h)及伤后不同时间(1 d、3 d、5 d、7 d、10 d)采血,检测血清中S-100B蛋白含量,比较其在伤后不同时期的血清S-100B蛋白含量.结果 正常体检者血清S-100B蛋白含量测定结果证实,正常人血清S-100B蛋白含量与年龄、性别无关.亚低温治疗组、常温治疗组患者伤后血清S-100B蛋白含量与对照组相比差异有统计学意义(P<0.01).伤后1 d、3 d、5 d、7 d、10 d时亚低温治疗组血清S-100B含量明显低于常温治疗组,差异有统计学意义(P(0.05).结论 血清S-100B蛋白在重型颅脑损伤的诊断巾有高度敏感性和特异性,是一种有效的生化指标.亚低温治疗对重型颅脑损伤具有脑保护作用.     

急性颅脑损伤后血清S100B蛋白含量变化

目的研究血清中S100B蛋白含量变化与颅脑损伤患者病情的关系。方法应用电化学发光免疫法测定36例急性颅脑损伤患者伤后不同时间血清S100B蛋白含量变化，结合GCS评分进行分析，并与对照组（20例无神经系统疾病史者）进行比较。结果颅脑损伤后24、48、72h和1周患者血清S100B蛋白水平均较对照组明显升高（P〈0．01）；颅脑损伤越严重，S100B蛋白水平升高越明显．伤后早期（48h内）重型（GCS评分≤7分）者血清S100B蛋白水平明显高于中、轻型（GCS评分≥8分）者（P〈0．01）。结论急性颅脑损伤后血清S100B含量明显升高，并与患者病情密切相关。     

血清S-100B对轻型颅脑损伤诊断价值的系统评价和Meta分析

目的系统评价血清学标志物S-100B对于轻型颅脑损伤（mTBI）患者颅内损伤的诊断价值。 方法计算机检索PubMed、EMbase、The Cochrane Library、中国知网、中国生物医学数据库、维普、万方数据库,筛选S-100B预测mTBI后颅内损伤的诊断性试验,检索时限为自建库至2022年5月27日。由2名研究员根据纳入和排除标准筛选文献、数据提取,并采用QUADAS-2工具评价纳入研究的偏倚风险,采用Meta-DiSc 1.4软件分析血清S-100B对mTBI的诊断价值。 结果共纳入21篇文献,包括8057例患者。Meta分析结果显示：S-100B诊断mTBI颅内损伤的诊断比值比为5.55（95%CI：3.47~8.87）,合并灵敏度为0.91（95%CI：0.88~0.93）,合并特异度为0.29（95%CI：0.28~0.30）,合并阳性似然比为1.35（95%CI：1.25~1.47）、合并阴性似然比为0.26（95%CI：0.16~0.44）。S-100B诊断mTBI颅内损伤的综合受试者工作特征曲线的曲线下面积为0.760。 结论S-100B对于mTBI患者颅内损伤有一定的诊断价值,可作为筛查工具辅助急诊医生进行筛查。     

S100B蛋白与颅脑损伤的研究现状

S100B蛋白是一种酸性钙结合蛋白,广泛存在于哺乳动物中枢神经系统内。生理量的S100B蛋白对神经系统的生长发育、神经细胞的增殖分化等方面具有重要影响,颅脑损伤时S100B蛋白不但高水平表达,而且溢出受损的细胞,通过受损的血脑屏障以高浓度出现于外周血清中。S100B蛋白具有神经毒性作用,在脑细胞损伤性炎症反应中扮演着重要角色。因此,检测颅脑损伤后S100B蛋白含量有助于早期预测损伤程度及预后;从分子水平阻断高浓度的S100B蛋白的神经毒性作用有望成为治疗重型颅脑损伤的一个新视窗。     

复方黄芪注射液对急性重型颅脑损伤患者血清NSE，MBP和S-100B含量的影响

目的观察复方黄芪注射液对急性重型颅脑损伤患者血清神经元特异性烯醇化酶（NSE），髓鞘碱性蛋白（MBP）和S-100蛋白B（S-100B）含量的影响。方法按标准选取急性重型颅脑损伤患者196例，随机分成常规治疗组和黄芪治疗组两组。黄芪治疗组在常规治疗基础上加用复方黄芪注射液治疗。治疗前和治疗后不同时间点分别检测患者血清NES、MBP和S-100B浓度,并行GCS评分，3个月后行GOS评分；同时检测96例健康成人血清的NES、MBP和S-100B的浓度，然后对所得资料进行统计学分析。结果急性重型颅脑损伤患者血清的NES、MBP和S-100B的浓度均显著高于健康成年人（P〈0．05）。治疗后黄芪治疗组血清NSE、MBP和S-100B均低于常规治疗组，差异均有显著性意义（P〈0．05）。黄芪治疗组在入院时的GCS评分与常规治疗组比较无显著性差异（P〉0．05），但治疗后1周和2周其GCS评分显著高于常规治疗组（P〈0．05）。治疗3月后其GOS评分显著高于常规治疗组（P〉0．05）。结论黄芪能降低急性重型颅脑损伤患者血清NSE，MBP，S-100B含量，并能改善患者的预后。     

重型颅脑损伤患者血清和脑脊液髓鞘碱性蛋白变？…

目的 探讨颅脑损伤患者血清和脑脊液（ＣＳＦ）中髓鞘碱性蛋白（ＭＢＰ）含量变化。方法 采用酶联免疫吸附法测定了６０例重型颅脑损伤患者的血清和ＣＳＦ中ＭＢＰ含量。结果 患者血清和ＣＳＦ中ＭＢＰ含量均增高,其上升水平与脑损伤类型及程度有关。结论同步检测血清和ＣＳＦ中ＭＢＰ含量变化,对判断颅脑损伤的程度及类型有一定实用价值。     

S-100 protein concentration in the cerebrospinal fluid of patients with Creutzfeldt-Jakob disease

We evaluated S-100 levels in paired cerebrospinal fluid (CSF) and serum samples in a group of 135 patients referred to the German Creutzfeldt-Jakob disease (CJD) surveillance unit from June 1993 to May 1995. The patients were seen in a prospective case control study. The diagnosis of probable CJD during life was made in any patient presenting with rapidly progressive dementia of less than 2 years’ duration, typical periodic sharp wave complexes (PSWCs) in the EEG and at least two of the following findings: myoclonus, visual/or cerebellar symptoms, pyramidal and/or extrapyramidal signs and/or akinetic mutism. Patients presenting with the above clinical signs and symptoms but without PSWCs were classified as possible, while those with a dementia of a duration exceeding 2 years and without PSWCs were classified as other. S-100 was determined in paired CSF and serum samples by a commercially available enzyme-linked immunosorbent assay. In a group of 76 patients with definite and probable CJD, S-100 concentration (median 25 ng/ml, range 2–117) in CSF was significantly higher (P < 0.0001) than in 32 patients diagnosed as other (median 4 ng/ml, range 1–19). Serum levels of S-100 were below 0.5 ng/ml in all groups. At a cut-off of 8 ng/ml an optimum sensitivity of 84.2% with a specificity of 90.6% for the diagnosis of CJD by the determination of S-100 in CSF is obtained. S-100 levels exceeding 8 ng/ml in CSF support the diagnosis of CJD in any patient presenting with rapidly progressive dementia. Received: 20 February 1997 Received in revised form: 16 July 1997 Accepted: 1 August 1997     

S-100B and neuron-specific enolase in serum of mild traumatic brain injury patients. A comparison with health controls

OBJECTIVES: The aim of the study was to determine whether serum concentrations of neuron-specific enolase (NSE) and S100-B in mild traumatic brain injury (MTBI) patients are higher than in serum of healthy controls. MATERIAL AND METHODS: Blood samples from 104 MTBI patients were taken shortly after the trauma for measurement of S-100B and NSE in serum. In 92 healthy persons these markers were also measured. Marker concentrations in serum of patients and controls were compared. In the patient group the relation between serum-marker concentrations and clinical symptoms and signs, that occurred shortly after the traumatic event, were evaluated. RESULTS: Median NSE concentration was only slightly higher in patients (9.8 microg/l; 10 to 90 percentile range 6.9 to 14.3 microg/ l) than in controls (9.4 microg/l; 6.3 to 13.3 microg/l). Median S-100B concentration was significantly higher in patients (0.25 microg/l; 0.00 to 0.68 microg/l) than in controls (0.02 microg/l; 0.00 to 0.13 microg/l). An association was found between S-100B concentrations and vomiting in patients. CONCLUSIONS: S-100B is a useful marker for brain damage in MTBI patients and seems to be associated with the presence of vomiting after the trauma.     

脑室系统出血纤溶治疗后脑脊液S-100B蛋白含量的变化及其意义

目的研究大鼠脑室系统出血纤溶治疗后脑脊液S-100B蛋白含量的变化及其意义。方法借助脑立体定向仪向大鼠脑室内注射30μl自身动脉血建立脑室出血动物模型;并分别行鞘内与脑室内注射尿激酶纤溶治疗,24h后通过解剖脑室观察脑室系统血凝块的变化,并通过酶联免疫吸附分析测定各组中脑脊液S-100B蛋白的含量。结果两治疗组脑室系统内血凝块较对照组明显减少,脑脊液S-100B含量较对照组明显降低(P0.05),但较正常组明显升高(P0.01)。脑脊液中S-100B含量鞘内治疗组明显低于脑室治疗组(P0.05)。结论大鼠脑室出血后经鞘内和脑室内注射尿激酶纤溶治疗均能加快血块溶解,降低脑脊液中S-100B蛋白含量。本结果提示脑脊液S-100B蛋白含量可能作为脑室内出血后判断脑损伤程度及疗效的一种标志物。     

高血压脑出血急性期血S-100蛋白含量变化及意义

目的探讨高血压脑出血患者急性期(AHCH) 血S-100蛋白含量变化及其与临床表现的关系。方法对56例高血压脑出血患者分别在24 h内和第3 d、第7 d进行血S-100蛋白定量测定,同时第3 d经腰穿测定颅内压(ICP)。50例“正常健康成人”进行血S-100蛋白定量测定作为对照组,并结合临床资料进行分析。结果高血压后7 d内血S-100蛋白含量显著高于正常对照组(P<0.001)。出血后24 h与7 d之间S-100蛋白水平无显著差异(P>0.05),24 h与3 d之间有显著差异(P<0.05),3 d与7 d之间血S-100蛋白含量无显著差异(P>0.05)。1个月后清醒组与非清醒组(包括死亡)之间血S-100蛋白水平有显著差异(P<0.05),56例患者ICP测得值与血S-100蛋白含量水平呈直线正相关(r=0.956,P<0.01)。结论高血压脑出血急性期血S-100蛋白含量显著升高,其能间接地预测病人的病情及脑损害程度,对预后的判断亦有指导意义。     

Neuron-specific enolase and S-100 protein levels in cerebrospinal fluid of patients with various neurological diseases

Neuron-specific enolase (NSE) and S-100 protein (S-100) levels in cerebrospinal fluid (CSF) were determined in 129 patients with various neurological diseases. The chronological changes of these nervous system-specific proteins in CSF were also examined in 3 patients with acute disorders. NSE and S-100 levels were elevated in many cases with acute conditions. These specific proteins did not increase simultaneously but independently. These results suggested that NSE and S-100 in CSF would be useful markers for damage of the nervous system and that measurement of both NSE and S-100 might positively indicate whether the damage was neuronal, glial or mixed in origin. Moreover, from the serial determination of these substances, they would be better markers than cell counts and total protein in CSF for the active injury for the nervous tissues.     

Prognostic significance of SSEP,BAEP and serum S-100B monitoring after aneurysm surgery

OBJECTIVE: Changes in evoked potentials (EPs) and increased levels of S-100B protein were used to identify cerebral ischemia or glial damage and to predict neurological outcome in aneurysm patients. MATERIAL AND METHODS: Somatosensory evoked potentials and Brainstem auditory-evoked potentials, and serum S-100B protein were simultaneously investigated pre- and postoperatively over a period of 10 days in 43 patients with 47 aneurysms (six in the posterior fossa). RESULTS: The EP scores showed a strong correlation with the clinical outcome. Sensitivity was 73%, and specificity 81%. Pathological S-100B levels >0.5 mg/l were equal in predictive values (correct positive eight, false positive six, correct negative 26, false negative three). Initially increased S-100B levels, long-lasting S-100B elevation, and secondary increasing S-100B values correlated with an unfavorable outcome. High peak S-100B values correlated with bad EP scores at discharge. EP deterioration was the first indicator anticipating S-100B elevation and clinical deterioration in five patients. There was a good correlation between pathological S-100B values or EP findings and infarction on CT scan. CONCLUSIONS: Both EPs and S-100B protein showed a comparable high predictive value for outcome. S-100B reflects the extent of primary brain damage after subarachnoid hemorrhage and time course of ongoing secondary brain damage. Evoked potentials assess the functional integrity and tended to react earlier than S-100B protein before definitive structural damage occurred.     

Myelin basic protein and S-100 antigen in cerebrospinal fluid of patients with multiple sclerosis in the acute phase

It has previously been demonstrated that both Myelin Basic Protein (MBP) and S-100 are released in the cerebrospinal fluid (CSF) of multiple sclerosis (MS) patients during acute phases of exacebation of the disease. In order to investigate the pathobiological significance of the release of these two proteins into the CSF, MBP and S-100 were assayed in 10 MS patients during the five weeks following onset of an acute exacerbation. MBP was detectable in CSF during the first three weeks after exacrebation, while S-100 was detectable during the entire period of observation, at least in some of the patients. MBP reached its highest CSF concentrations during the first two weeks while S-100 did so in the third week, decreasing thereafter. This difference in time of presence of MBP and S-100 in the CSF is probably due to the different biological origin, MBP being a marker of myelin sheath injury, and S-100, more probably, of astrocytic activity.

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Sommario È stato precedentemente dimostrato che sia la proteina basica della mielina (PBM) che la S-100 vengono liberate nel liquido cefalo-rachidiano (LCR) durante in periodi di esacerbazione della sclerosi multipla (SM). Al fine di approfondire ulteriormente il significato patobiologico della liberazione di queste due proteine nel LCR abbiamo eseguito uno studio quantitativo di PBM e S-100 in dieci malati di SM durante un periodo di 5 settimane successive ad una ricaduta. La PBM è risultata dosabile durante le prime tre settimane, mentre la S-100 è risultata essere presente nel LCR durante l'intero periodo di osservazione, almeno in alcuni dei pazienti. La PBM ha raggiunto i suoi maggiroi livelli durante le prime due settimane. La S-100, invece, durante la terza settimana, dopo di che vi è stata una netta riduzione dei suoi livelli liquorali. Questa differenza nei tempi di presenza di PBM ed S-100 nel LCR è probabilmente dovuta alla differente origine biological delle due proteine. La PBM, infatti, è marcatrice di lesione della guaina mielinica, la S-100 invece, con più probabilità, di attività dellule astrocitarie.

     

单纯疱疹病毒性脑炎患者脑脊液和血清S-100 B蛋白及NSE的测定

目的　测定单纯疱疹病毒性脑炎 (HSE)患者脑脊液和血清中的S 1 0 0B蛋白和神经元特异性烯醇化酶(NSE)含量 ,并探讨S 1 0 0B蛋白和NSE含量对HSE患者脑损害的评估价值。方法　 4 2例HSE患者 (昏迷组 1 6例 ,无昏迷组 2 6例 )和 2 2例正常人对照组脑脊液和血清的S 1 0 0B蛋白和NSE含量 ,均采用酶联免疫吸附试验双抗体夹心法检测 ,并进行动态观察。结果　①HSE昏迷组的脑脊液和血清S 1 0 0B蛋白和NSE含量显著高于无昏迷组和对照组 (P均小于 0 0 1 ) ,无昏迷组脑脊液S 1 0 0B蛋白和NSE含量与对照组也有差异 (P <0 0 1和 <0 0 1 ) ;②脑脊液S 1 0 0B蛋白和NSE含量随HSE患者病情变化而发生相应的改变 ;③脑脊液S 1 0 0B蛋白和NSE含量分别与其各自的血清含量呈正相关。结论　脑脊液和血清的S 1 0 0B蛋白和NSE可以作为HSE患者脑损害的标志物 ,其含量的高低与胶质细胞和神经元的损害程度有关