【摘要】 目的　研究重型脑损伤后血清S - 10 0B蛋白浓度变化 ,以期为重型脑损伤后原发性和继发性脑损害监测及预后评估提供直观的定量手段。　方法　对 2 0 0 2年 1月～ 2 0 0 2年 12月4 0例重型脑损伤住院患者伤后 12h～ 4d进行连续血清S - 10 0B蛋白浓度检测 ,并结合临床表现及格拉斯哥预后评分 (GOS)进行比较分析。　结果　本组 4 0例重型脑损伤患者伤后 12h血清S- 10 0B蛋白浓度均显著高于正常对照组 ,不同严重程度组之间S - 10 0B蛋白浓度差异存在非常显著性意义 (P <0 .0 1)。以伤后 12h血清S - 10 0B蛋白浓度 2 .0 0 μg/L为标准评估预后 ,其特异度为91% ,敏感度 72 % ,相对危险度 4 .33。本组 4 0例重型脑损伤患者伤后S - 10 0B蛋白浓度虽均呈下降趋势 ,但仍高于正常值 ,且预后恶劣组伤后各天S - 10 0B蛋白浓度均持续显著高于预后良好组 ,两组差异有非常显著性意义 (P <0 .0 1)。　结论　重型脑损伤后血清S - 10 0B蛋白浓度变化对原发性和继发性脑损害程度以及预后的评估有重要意义 ,为临床救治效果及病情转归的判断提供了有效手段。更多还原

【Abstract】 Objective To observe the concentration changes of plasma S-100B following severe brain injuries so as to quantitatively monitor primary and secondary brain injury and evaluate the prognosis after severe brain injury. Methods A total of 40 patients with severe brain injuries were involved in this study. Serial concentration of S-100B in serum was measured in all cases from day 1 to day 4 after severe brain injury in order to evaluate the prognosis in combination with clinical symptom and Glasgow Coma Scale. Results The concentration of S-100B in serum of both groups were higher than that of normal group. S-100B at 2.00 μg/L within 12 hours after brain injuries was set as the evaluating standard that had specificity of 91%,sensitivity of 72% and relative risk of 4.3. After brain injuries,the concentration of S-100B in all the cases decreased but was still higher than the normal value. Furthermore,the concentrtion of S-100B in the group with poor prognosis was continuously and significantly higher than that in the group with sound prognosis,where a significant difference exists ( P <0.01). Conclusions S-100B is a promising predictor for assessing primary and secondary damage of central nervous system and predicting prognosis after severe brain injury and hence provides an important way to assess the clinical treatment result and disease improvement.更多还原