动脉瘤性蛛网膜下腔出血后血清S-100B蛋白水平的临床意义

摘要

Objective To study the significance of dynamic change of serum S-100B protein level of patients with subarachnoid aneurysmal hemorrhage( SAH ). Methods Double antibody sandwich ELISA was applied to determinate serum S-100B protein levels of 90 SAH cases on the 1st,2nd,3rd,7th day after hemorrhage,and in combination with Hunt-Hess classification method,a factors analysis of GCS,intracranial pressure( ICP ),different parts of the aneurysm, aneurysm clipping operation/interventional embolization was performed. Results (T) serum S-100B protein level increased immediately in the onset of SAH;higher Hunt-Hess level,significantly higher S-100B at different time points ( P <0.01 ); Lower GCS score, significantly higher S-100B at different time points( P <0.01 ); Compared with normal group,S-100B at different points in the increased ICP group increased significantly( P < 0. 01 ). (2) There was no significant difference in the serum S-100B protein level among different parts of SAH( P >0.05 );Serum S-100B protein level showed no significant difference between aneurysm clipping operation and interventional embolization( P >0. 05 ). Conclusion Dynamic changes of serum S-100B protein level can reflect the degree of brain damage in SAH patients, which is important to assessment of predicting the delayed cerebral vasospasm caused by secondary brain damage.%目的 探讨动脉瘤性蛛网膜下腔出血(SAH)患者血清S-100B蛋白水平变化的意义.方法 采用双抗体夹心ELISA法检测90例SAH后1、2、3、7 d时血清S-100B蛋白水平,并结合Hunt-Hess分级法、GCS、颅内压、不同部位动脉瘤、动脉瘤夹闭手术或介入栓塞等各种因素进行分析.结果 (1)SAH患者发病后血清S-100B蛋白浓度立即升高;Hunt-Hess分级级别加大,不同时点S-100B越明显升高(P＜0.01);在GCS评分越低,不同时点S-100B越明显升高(P＜0.01);颅内压增高组不同时点S-100B比正常组升高(P＜0.01).(2)不同部位动脉瘤出血后,血清S-100B蛋白水平差异无统计学意义(P＞0.05);动脉瘤夹闭手术者与介入栓塞者血清S-100B蛋白水平差异无统计学意义(P＞0.05).结论 动态血清S-100B蛋白水平可反映SAH后患者脑损害程度,对预测迟发性脑血管痉挛继发性脑损害的评估有重要意义.