Clinical Utility of the Protein S100B to Evaluate Traumatic Brain Injury in the Presence of Acute Alcohol Intoxication
Clinical Utility of the Protein S100B to Evaluate Traumatic Brain Injury in the Presence of Acute Alcohol Intoxication
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DOI：
10.1097/htr.0b013e31820e6840
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发表时间：
2012-03-01
影响因子：
2.4
通讯作者：
Brubacher, Jeffrey R.
中科院分区：
文献类型：
--
作者：
Lange, Rael T.;Iverson, Grant L.;Brubacher, Jeffrey R.
目的：研究蛋白质 S100B 作为急性酒精中毒时脑外伤 (TBI) 生物标志物的作用。参与者：共有 159 名就诊于加拿大不列颠哥伦比亚省温哥华大型城市 1 级创伤中心的患者。患者被分为4个临床组——医学对照（MC）、创伤对照（TC）、无并发症的轻度TBI（MTBI）和明确TBI（DTBI）——以及受伤后2天酒精中毒组（即清醒组和醉酒组）。程序：在受伤后 8 小时内采集血样。主要结果测量：蛋白质 S100B 浓度（μ g/L；Sangtec 100 Elisa、DiaSorin、Stillwater、Minnesota）。结果：TBI 患者的 S100B 水平高于 MC 和 TC 组（DTBI 和 MTBI>TC 和 MC）。 S100B水平与脑损伤严重程度呈正线性关系（DTBI>MTBI）。受伤时饮酒通常不会影响 S100B 水平。 S100B 水平对大多数患者具有中等诊断准确性，但 DTBI 清醒组除外，其中 S100B 水平具有非常高的诊断准确性。结论：无并发症 MTBI 和 DTBI 患者的 S100B 水平远高于 MC 和 TC 参与者。该生物标志物在酒精中毒情况下检测 DTBI 具有中等诊断准确性，在清醒患者中具有非常高的准确性。
Objective: To examine the role of the protein S100B as a biomarker for traumatic brain injury (TBI) in the presence of acute alcohol intoxication. Participants: A total of 159 patients who presented to a large urban level 1 trauma center in Vancouver, British Columbia, Canada, were included. Patients were classified into 4 clinical groups-medical controls (MC), trauma controls (TC), uncomplicated mild TBI (MTBI), and definite TBI (DTBI)-and 2 day-of-injury alcohol intoxication groups (ie, sober and intoxicated). Procedure: Blood samples were collected within 8 hours of injury. Main Outcome Measure: Protein S100B concentration (mu g/L; Sangtec 100 Elisa, DiaSorin, Stillwater, Minnesota). Results: Higher S100B levels were found in patients who sustained a TBI than in those in the MC and TC groups (DTBI & MTBI>TC & MC). There was a positive linear relation between S100B levels and brain injury severity (DTBI>MTBI). Alcohol consumption at the time of injury did not generally affect S100B levels. The S100B levels had medium diagnostic accuracy for the majority of patients, with the exception of the DTBI-sober group in which S100B levels had very high diagnostic accuracy. Conclusion: Patients with uncomplicated MTBIs and DTBIs had much higher levels of S100B than MC and TC participants. This biomarker had medium diagnostic accuracy for detecting DTBI in the presence of alcohol intoxication and very high accuracy in sober patients.