High serum S100B levels for trauma patients without head injuries
High serum S100B levels for trauma patients without head injuries
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DOI：
10.1097/00006123-200106000-00012
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发表时间：
2001-06-01
期刊：
影响因子：
4.8
通讯作者：
Settergren, G
中科院分区：
文献类型：
--
作者：
Anderson, RE;Hansson, LO;Settergren, G
目的：对头部创伤患者的研究表明，脑组织损伤的血清标志物S100 B与神经放射学结果之间存在相关性。最近的研究表明，心脏手术后血清S100 B水平的升高具有脑外起源，可能是手术创伤的脂肪、肌肉和骨髓。目前的研究探讨了多发性创伤患者没有头部外伤，以确定是否软组织和骨损伤可能混淆解释血清S100 B浓度升高的患者后，头部traumature.METHODS：一个商业化的测定方法被用来确定血清S100 B浓度为正常人群（n = 459）和多发性创伤患者没有头部损伤（n = 17）。两种亚型的S100 B（S100 A1 B和S100 BB）的浓度测定使用单独的非商业化assays.Results：正常健康人群的平均血清S100 B浓度为0.032 μ g/L（中位数，0.010 μ g/L;标准差，0.040 μ g/L）。97.5%和95%参考上限分别为0.13和0.10 mug/L。未观察到重大的年龄或性别差异。在创伤患者中，血清S100 B水平在骨折（范围，2-10 mug/L）和胸部挫伤无骨折（范围，0.5-4 mug/L）后最高。烧伤（范围，0.8-5微克/升）和轻微瘀伤;也产生增加S100 B水平。结论：创伤后，即使没有头部创伤，也会导致血清中S100 B的高浓度。由于脑外的贡献，解释多发伤后立即升高的S100 B浓度可能是困难的。S100 B可能具有排除创伤后脑组织损伤的阴性预测值。同样，非急性S100 B测量可能比急性测量具有更大的预后价值。
OBJECTIVE: Studies of patients with head trauma have demonstrated a correlation between a serum marker of brain tissue damage, namely S100B, and neuroradiological findings. It was recently demonstrated that the increases in serum S100B levels after heart surgery have extracerebral origins, probably surgically traumatized fat, muscle, and bone marrow. The current study examined multiltrauma patients without head trauma, to determine whether soft-tissue and bone damage might confound the interpretation of elevated serum S100B concentrations for patients after head trauma.METHODS: A commercial assay was used to determine serum S100B concentrations for a normal population (n = 459) and multitrauma patients without head injury (n = 17). Concentrations of the two subtypes of S100B (S100A1B and S100BB) were determined using separate noncommercial assays.RESULTS: The mean serum S100B concentration for a normal healthy population was 0.032 mug/L (median, 0.010 mug/L; standard deviation, 0.040 mug/L). The upper 97.5% and 95% reference limits were 0.13 and 0.10 mug/L, respectively. No major age or sex differences were observed. Among trauma patients, serum S100B levels were highest after bone fractures (range, 2-10 mug/L) and thoracic contusions without fractures (range, 0.5-4 mug/L). Burns (range, 0.8-5 mug/L) and minor bruises;also produced increased S100B levels. S100A1B and S100BB were detected in all samples.CONCLUSION: Trauma, even in the absence of head trauma, results in high serum concentrations of S100B. Interpretation of elevated S100B concentrations immediately after multitrauma may be difficult because of extracerebral contributions. S100B may have a negative predictive value to exclude brain tissue damage after trauma. Similarly, nonacute S100B measurements may be of greater prognostic value than acute measurements.