血清星形胶质源性蛋白、神经元特异性烯醇化酶对颅脑损伤患者病情及预后的评估价值

The value of serum S100β and NSE for evaluating the condition and prognosis of patients with craniocerebral injury

摘要:

目的 探讨血清星形胶质源性蛋白（S100β）、神经元特异性烯醇化酶（NSE）联合检测对颅脑损伤患者病情及预后的评估价值。方法 选取2018年2月—2021年6月齐齐哈尔医学院附属第二医院收治的颅脑损伤患者103例作为研究对象。收集所有患者临床资料，治疗后随访3个月观察其预后情况。比较治疗前不同病情严重程度患者血清S100β、NSE水平及影响患者预后的因素，分析血清S100β、NSE对颅脑损伤患者预后的预测价值。结果 103例颅脑损伤患者中，轻度28例，中度41例，重度34例。轻度组S100β、NSE低于中、重度组（P <0.05），中度组S100β、NSE低于重度组（P <0.05）。103例颅脑损伤患者中，20例预后不良，83例预后良好。预后不良组格拉斯哥昏迷评分（GCS）低于预后良好组（P <0.05），APACHE Ⅱ评分、SOFA评分、颅内压、乳酸、S100β、NSE高于预后良好组（P <0.05）。多因素Logistic回归分析结果显示，GCS评分［O^R=5.463（95% CI：2.402，12.427）］、乳酸［O^R=3.846（95% CI：1.691，8.749）］、S100β［O^R=3.408（95% CI：1.498，7.752）］、NSE［O^R=4.063（95% CI：1.786，9.243）］是影响颅脑损伤患者预后的独立因素（P <0.05）。血清S100β、NSE及两者联合预测颅脑损伤患者预后的敏感性分别为70.00%、75.00%和70.00%，特异性分别为75.90%、72.29%和90.36%，AUC分别为0.764、0.742和0.908。结论 血清S100β、NSE水平与颅脑损伤患者病情及预后有关，两者联合预测颅脑损伤患者预后效能良好。

Abstract:

Objective To explore the value of the combined detection of serum S100 calcium-binding protein B (S100β) and neuron-specific enolase (NSE) in evaluating the condition and prognosis of patients with craniocerebral injury.Methods The 103 patients with craniocerebral injury admitted to our hospital from February 2018 to June 2021 were selected, and the serum levels of S100β and NSE were detected in these patients. The clinical data of the patients were collected, and the prognosis was observed 3 months after the treatment. The serum levels of S100β and NSE were compared among patients with different severity of craniocerebral injury before the treatment. The factors affecting the prognosis of patients with craniocerebral injury were determined, and the predictive values of serum S100β and NSE for the prognosis of patients with craniocerebral injury were analyzed.Results Among 103 patients with craniocerebral injury, there were 28 mild cases, 41 moderate cases, and 34 severe cases. The serum levels of S100β and NSE in mild cases were lower than those in moderate and severe cases (P < 0.05), and they were even lower in the moderate cases than in the severe cases (P < 0.05). Of all these patients, 20 had a poor prognosis, and the rest 83 had a good prognosis. The Glasgow Coma Scale (GCS) score was lower in patients with a poor prognosis than those with a good prognosis (P <0.05), while the Acute Physiology and Chronic Health Evaluation II (APACHE) score, Sequential Organ Failure Assessment (SOFA) score, intracranial pressure, and the levels of lactic acid, S100β and NSE were higher in patients with a poor prognosis than those with a good prognosis (P < 0.05). The Logistic multivariable regression analysis showed that GCS score [O^R = 5.463 (95% CI: 2.402, 12.427) ] and levels of lactic acid [O^R= 3.846 (95% CI: 1.691, 8.749) ], S100β [O^R = 3.408 (95% CI: 1.498, 7.752) ] and NSE [O^R = 4.063 (95% CI: 1.786, 9.243) ] were independent factors affecting the prognosis of patients with craniocerebral injury (P < 0.05). The sensitivities of S100β, NSE and their combination in predicting the prognosis of patients with craniocerebral injury were 70.00%, 75.00% and 70.00%, the specificities were 75.90%, 72.29% and 90.36%, and the areas under the ROC curves were 0.764, 0.742 and 0.908.Conclusions The serum levels of S100β and NSE are related to the condition and prognosis of patients with craniocerebral injury, and the combined detection of the two indicators is effective in predicting the prognosis of patients with craniocerebral injury.