颅脑创伤后脑脊液S100β、NSE动态变化与颅内压、脑灌注压的关系分析

doi:10.3877/cma.j.issn.2095-9141.2017.03.002

中华神经创伤外科电子杂志 ›› 2017, Vol. 03 ›› Issue (03) : 132 -135. doi: 10.3877/cma.j.issn.2095-9141.2017.03.002

所属专题：文献；

临床研究

颅脑创伤后脑脊液S100β、NSE动态变化与颅内压、脑灌注压的关系分析

于泽奇¹^,^†(

), 江继鹏¹, 董晓煜², 王婧怡³

^1. 300162　天津，武警后勤学院附属医院脑科医院
^2. 100621　北京，北京武警总队三支队卫生队
^3. 300309　天津，武警后勤学院附属医院检验科

收稿日期:2017-05-03 出版日期:2017-06-15
通信作者: 于泽奇
基金资助:
国家自然科学基金项目(31200809); 武警部队后勤科研项目(WJHQ2012-20); 军队技术产品研究重大项目(AWS15J001); 天津市科技计划项目(15ZXLCSY00040)

Relationship between dynamic changes of cerebrospinal fluid S100β, NSE and intracranial pressure, cerebral perfusion pressure after TBI

Zeqi Yu¹^,^†(), Jipeng Jiang¹, Xiaoyu Dong², Jingyi Wang³

^1. Neurology and Neurosurgery Hospital, Affiliated Hospital of Logistics College of Chinese People’s Armed Police Force, Tianjin 300162, China
^2. Medical Unit of Three Detachment of Beijing Armed Police Corps, Beijing 100621, China
^3. Department of Clinical Laboratory of Logistics University of Chinese People’s Armed Police Force, Tianjin 300309, China

Received:2017-05-03 Published:2017-06-15
Corresponding author: Zeqi Yu
About author:
Corresponding author: Yu Zeqi, Email: yuzeqidick@163.com

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引用本文：

于泽奇, 江继鹏, 董晓煜, 王婧怡. 颅脑创伤后脑脊液S100β、NSE动态变化与颅内压、脑灌注压的关系分析[J]. 中华神经创伤外科电子杂志, 2017, 03(03): 132-135.

Zeqi Yu, Jipeng Jiang, Xiaoyu Dong, Jingyi Wang. Relationship between dynamic changes of cerebrospinal fluid S100β, NSE and intracranial pressure, cerebral perfusion pressure after TBI[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2017, 03(03): 132-135.

目的

分析颅脑创伤后脑脊液中S100β、神经元特异性烯醇化酶（NSE）动态变化与颅内压（ICP）、脑灌注压（CPP）的关系。

方法

通过酶联免疫吸附法（ELISA）测定武警后勤学院附属医院脑科医院自2015年1月至2016年8月收治的60例颅脑创伤患者伤后6、12、24、48、72 h脑脊液中S100β、NSE浓度，同时对患者ICP及CPP进行动态监测，通过Spearman相关性检验分析脑脊液中S100β、NSE动态变化与ICP、CPP的关系。

结果

入院后6、12、24 h脑脊液中S100β呈现上升趋势，48、72 h较24 h有所下降，但不同时间点脑脊液中S100β浓度均显著高于正常组，差异具有统计学意义（P<0.05）；入院后6、12、24、48、72 h脑脊液、ICP均呈现上升趋势，而CPP呈现下降趋势，与正常组相比差异具有统计学意义（P<0.05）；Spearman相关性分析显示颅脑创伤后24 h脑脊液中S100β与ICP正相关，与CPP负相关，差异具有统计学意义（P<0.05），而不同时间点NSE水平均与ICP正相关，与CPP负相关，差异具有统计学意义（P<0.05）。

结论

颅脑创伤后脑脊液中S100β、NSE表达水平与ICP、CPP密切相关，加强对上述指标的动态监测有利于继发性脑损伤的诊疗。

关键词: 颅脑创伤, S100β, 神经元特异性烯醇化酶, 颅内压, 脑灌注压

Objective

To analyze the relationship between the dynamic changes of cerebrospinal fluid S100β, neuron specific enzyme (NSE) and intracranial pressure, cerebral perfusion pressure after traumatic brain injury (TBI).

Methods

The concentrations of S100β and NSE in cerebrospinal fluid of 60 patients were determined by enzyme-linked immunosorbent assay (ELISA) at 6, 12, 24, 48 and 72 h after TBI. The intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were monitored. The relationship between cerebrospinal fluid S100β, NSE and ICP, CPP in cerebrospinal fluid was analyzed by Spearman correlation analysis.

Results

Cerebrospinal fluid S100β showed an increasign trend at 6, 12 and 24 h after admission, but at 48 and 72 h, it was lower than at 24 h. What’s more, the concentrations of S100β in cerebrospinal fluid at different time points were significantly higher than those in control group (P<0.05). Cerebrospinal fluid and intracranial pressure showed an increasing trend, while CPP showed a decreasing trend at 6, 12, 24, 48 and 72 h after admission. Compared with the normal group, there were significant differences (P<0.05); Spearman correlation analysis showed that S100β was positively correlated with ICP in cerebrospinal fluid at 24 h after traumatic brain injury, and negatively correlated with CPP (P<0.05), while NSE levels were positively correlated with ICP at different time points, and negatively correlated with CPP (P<0.05).

Conclusion

The levels of S100β, NSE in cerebrospinal fluid are closely related to ICP and CPP, and the dynamic monitoring of these indexes is beneficial to the diagnosis and treatment of secondary brain injury.

Key words: Traumatic brain injury, S100β, Neuron-specific enolase, Intracranial pressure, Cerebral perfusion pressure

表1 颅脑创伤患者伤后不同时间点脑脊液S100β浓度、神经元特异性烯醇化酶浓度、颅内压、脑灌注压水平比较

组别	例数	S100β（ng/ml）	NSE（ng/ml）	颅内压（mmHg）	脑灌注压（mmHg）
对照组	50	0.08±0.02	6.00±1.03	13.00±2.02	80.35±6.24
6h	60	7.72±1.18^a	34.25±7.32^b	20.02±1.47^c	62.54±1.50^d
12 h	60	8.93±0.72^a	36.68±8.00^b	23.01±2.06^c	59.72±1.62^d
24 h	60	11.79±2.01^a	40.47±6.92^b	25.98±1.24^c	57.50±1.78^d
48 h	60	5.41±0.22^a	43.85±7.25^b	30.00±1.84^c	55.15±2.03^d
72 h	60	3.68±0.47^a	46.16±7.64^b	30.89±1.00^c	55.00±1.59^d
F值	?	49.430	13.962	49.368	30.736
P值	?	<0.01	<0.01	<0.01	<0.01

表1 颅脑创伤患者伤后不同时间点脑脊液S100β浓度、神经元特异性烯醇化酶浓度、颅内压、脑灌注压水平比较

组别	例数	S100β（ng/ml）	NSE（ng/ml）	颅内压（mmHg）	脑灌注压（mmHg）
对照组	50	0.08±0.02	6.00±1.03	13.00±2.02	80.35±6.24
6h	60	7.72±1.18^a	34.25±7.32^b	20.02±1.47^c	62.54±1.50^d
12 h	60	8.93±0.72^a	36.68±8.00^b	23.01±2.06^c	59.72±1.62^d
24 h	60	11.79±2.01^a	40.47±6.92^b	25.98±1.24^c	57.50±1.78^d
48 h	60	5.41±0.22^a	43.85±7.25^b	30.00±1.84^c	55.15±2.03^d
72 h	60	3.68±0.47^a	46.16±7.64^b	30.89±1.00^c	55.00±1.59^d
F值	?	49.430	13.962	49.368	30.736
P值	?	<0.01	<0.01	<0.01	<0.01

表2 脑脊液S100β与颅内压、脑灌注压的关系

时间点	颅内压		脑灌注压
时间点	Spearman相关系数	P值	Spearman相关系数	P值
6h	0.979	<0.01	-0.995	<0.01
12 h	0.964	<0.01	-0.967	<0.01
24 h	0.959	<0.01	-0.999	<0.01

表2 脑脊液S100β与颅内压、脑灌注压的关系

时间点	颅内压		脑灌注压
时间点	Spearman相关系数	P值	Spearman相关系数	P值
6h	0.979	<0.01	-0.995	<0.01
12 h	0.964	<0.01	-0.967	<0.01
24 h	0.959	<0.01	-0.999	<0.01

表3 脑脊液神经元特异性烯醇化酶与颅内压、脑灌注压的关系

时间点	颅内压		脑灌注压
时间点	Spearman相关系数	P值	Spearman相关系数	P值
6h	0.950	<0.01	-0.987	<0.01
12 h	0.999	<0.01	-0.999	<0.01
24 h	0.932	<0.01	-0.995	<0.01
48 h	0.996	<0.01	-0.939	<0.01
72 h	0.913	<0.01	-0.973	<0.01

表3 脑脊液神经元特异性烯醇化酶与颅内压、脑灌注压的关系

时间点	颅内压		脑灌注压
时间点	Spearman相关系数	P值	Spearman相关系数	P值
6h	0.950	<0.01	-0.987	<0.01
12 h	0.999	<0.01	-0.999	<0.01
24 h	0.932	<0.01	-0.995	<0.01
48 h	0.996	<0.01	-0.939	<0.01
72 h	0.913	<0.01	-0.973	<0.01

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