中枢神经系统疾患与S-100β蛋白的关系

目的：回顾中枢神经系统疾患时S-100β蛋白在脑组织、血液和脑脊液中的变化情况，并试图找到与疾病的早期评估、病情严重程度及预后的关系。 资料来源：利用计算机检索Medline1996-01／2005-01有关中枢神经系统疾患时S-100β蛋白表达变化情况的文献，检索词“S-100β，限定语言类型为English。同时检索中文期刊全文数据库1996-01／2005-01的文献，检索词为“S-100β”，限定语言类型为中文。资料选择：浏览文题和摘要，选择与中枢神经系统疾患发生、发展及实验评估有关的文献，查找典型文献的原文阅读。 资料提炼：检索到的关于脑缺血、创伤性脑损伤、缺血缺氧性脑病、中枢神经系统炎症和癫痫S-100β蛋白的表达与作用的文献共65篇，选择观点相似的文献引用28篇。 资料综合：①脑缺血后的早期S-100β在脑脊液和血液中即有显著意义的升高，并且同梗死体积、临床状态和功能预后具有相关性。②血清S-100β可作为判断缺氧缺血性脑病病情程度的客观依据和早期诊断缺氧缺血性脑病以及预后评估的主要指标。③血清S-100β可作为急性全脑缺血（心脏停搏）后24h患者预后可靠的标志物。④创伤性脑损伤后S-100β血清水平的升高同损伤的严重程度和神经放射学发现均有相关性，并为创伤性脑损伤预后不良的指标．⑤S-100β水平在其他中枢神经系统疾患如炎症、胶质细胞瘤和癫痫等也有不同程度的变化。 结论：血清和脑脊液中S-100β水平同中枢神经系统疾患的发生、发展和临床状态关系密切，有望成为评估中枢神经系统疾患临床状态及预后的实验室指标。     

S100B和脐血铅水平与缺氧缺血性脑病新生儿神经精神运动评分的关系

目的研究S100B和脐血铅水平与缺氧缺血性脑病(HIE)新生儿6月龄神经精神运动评分(DQ)的关系。方法以脐血铅水平60μg/L为标准,将59例中重度HIE新生儿分为低血铅HIE组38例及高血铅HIE组21例,两组分别进行S100B水平及6月龄DQ测定,同时以健康新生儿30例作为对照。结果 HIE组与对照组脐血铅水平差异无统计学意义(P>0.05);HIE组血清S100B水平显著高于对照组(P<0.01);高血铅HIE组与低血铅HIE组S100B水平差异无统计学意义(P>0.05);高血铅HIE组比低血铅HIE组6月龄DQ显著降低(P<0.01)。高血铅HIE组和低血铅HIE组S100B水平与6月龄DQ均呈负相关(r分别为-0.826、-0.729,P均小于0.05)。结论 S100B对HIE患儿病情监测和判断预后有一定的意义。脐血铅含量增高可对婴儿神经行为发育产生不良影响,影响HIE患儿的预后。     

脑出血患者血清及脑脊液中白细胞介素1β和S-100蛋白水平的变化

目的：探讨脑出血患者血清、脑脊液炎性因子白细胞介素1β水平变化与出血性脑损伤的相关性。方法：选择第三军医大学大坪医院野战外科研究所神经内科2002—05/12住院脑出血患者53例为脑出血组，同期住院的中枢神经系统非器质性疾病患者25例为对照组。脑出血患者急性期（病程7d内）和恢复期（〉21d）、对照组于人院后3d内采用双抗体夹心ELISA法测定血清、脑脊液中白细胞介素1β和S-100蛋白水平；采用脑卒中患者临床神经功能缺损程度评分标准评价脑出血患者神经功能缺损情况；采用直线回归法分析脑出血急性期患者血清、脑脊液中白细胞介素1β与S-100蛋白相关性，出血量、神经功能缺失评分与血清、脑脊液中白细胞介素1β、S-100蛋白相关性。结果：78例进入结果分析。①白细胞介素1β水平：血清中脑出血急性期患者高于恢复期和对照组[（3．57&;#177;0．53），（2．24&;#177;0．18），（2．17&;#177;0．17）ng／L，P〈0．01]；脑脊液中脑出血恢复期患者高于对照组，但低于急性期患者[（2．17&;#177;0．12），（2．32&;#177;0．17），（2．08&;#177;0．13）ng／L,P〈0．01]。②S-100蛋白水平：无论血清中还是脑脊液中，脑出血急性期和恢复期患者均高于对照组（P〈0．01），脑出血急性期高于恢复期患者（P〈0．01）。③相关性分析结果：脑出血急性期白细胞介素1β与S-100蛋白水平呈显著正相关（r血清=0．698，r脑脊液=0．587，P〈0．01）；患者出血量、神经功能缺损程度与血清、脑脊液中白细胞介素1β和S-100蛋白水平显著相关（P〈0．05，0．01）。结论：炎性机制与脑出血继发性损伤有关；s-100蛋白变化可客观反映出血性脑损伤程度。     

新生儿缺氧缺血性脑病S-100β蛋白表达的临床意义研究

目的探讨缺氧缺血性脑病(HIE)患儿血清S-100β蛋白水平检测的临床意义。方法用酶联免疫吸附法(ELISA)检测70例HIE新生儿和60例同期住院上呼吸道感染新生儿血清S-100β蛋白水平。结果中度和重度HIE新生儿血清S-100β蛋白含量水平较对照组明显升高,重度组S-100β蛋白含量水平较轻中度组增高,轻度组与对照组比较血清S-100β蛋白含量水平不升高。结论 S-100β蛋白可作为脑损伤的生化标志物,能反映疾病的严重程度,对临床有很好的参考价值。     

新生儿缺氧缺血性脑病S-100β蛋白表达的临床意义研究

目的探讨缺氧缺血性脑病（HIE）患儿血清S-100β蛋白水平检测的临床意义。方法用酶联免疫吸附法（ELISA）检测70例HIE新生儿和60例同期住院上呼吸道感染新生儿血清S-100β蛋白水平。结果中度和重度HIE新生儿血清S-100β蛋白含量水平较对照组明显升高,重度组S-100β蛋白含量水平较轻中度组增高,轻度组与对照组比较血清S-100β蛋白含量水平不升高。结论 S-100β蛋白可作为脑损伤的生化标志物,能反映疾病的严重程度,对临床有很好的参考价值。     

S100蛋白:脑损伤的生化标志物

1965年Moore首次自牛脑组织中分离出一种亚细胞组分,被认为是含有神经系统特异的蛋白质,因为这个成分在中性pH时能溶解在100％的饱和硫酸铵溶液中而得名,叫做S-100蛋白。近年来,随着神经免疫学、神经生物化学和神经分子生物学的发展,有关S100蛋白的研究非常活跃,许多研究已证实测定生物体液中S-100蛋白浓度．可以作为脑损伤的一种标志物。     

检测血清和尿液S100B蛋白在新生儿窒息中的意义

目的探讨血、尿S100B蛋白含量以及尿S100B蛋白／肌酐的比值对新生儿窒息的早期诊断和病情监测的应用价值。方法检测了63例新生儿窒息患者出生后第1、2、3天的血、尿S100B蛋白含量和尿S100B蛋白／肌酐比值，并在1周内对试验组患儿进行分类。结果重度窒息患儿3d内血、尿S100B蛋白及尿S100B蛋白比值均高于对照组（P〈0．05）；轻度窒息组患儿第1天血、尿S100B蛋白及尿S100B蛋白比值高于健康对照组（P〈O．05），从第2天起与健康对照组比较差异无统计学意义；尿S100B蛋白／肌酐比值比单独检测尿S100B蛋白更稳定、可靠，能提高诊断的灵敏度、特异度。结论血、尿S100B蛋白能客观地反映窒息患儿的病情，对提高缺氧缺血性脑病（HIE）的早期诊断和病情监测具有一定的实用价值。     

检测血清和尿液S100B蛋白在新生儿窒息中的意义

目的 探讨血、尿S100B蛋白含量以及尿S100B蛋白/肌酐的比值对新生儿窒息的早期诊断和病情监测的应用价值.方法 检测了63例新生儿窒息患者出生后第1、2、3天的血、尿S100B蛋白含量和尿S100B蛋白/肌酐比值,并在1周内对试验组患儿进行分类.结果 重度窒息患儿3 d内血、尿S100B蛋白及尿S100B蛋白比值均高于对照组(P<0.05);轻度窒息组患儿第1天血、尿S100B蛋白及尿S100B蛋白比值高于健康对照组(P<0.05),从第2天起与健康对照组比较差异无统计学意义;尿S100B蛋白/肌酐比值比单独检测尿S100B蛋白更稳定、可靠,能提高诊断的灵敏度、特异度.结论 血、尿S100B蛋白能客观地反映窒息患儿的病情,对提高缺氧缺血性脑病(HIE)的早期诊断和病情监测具有一定的实用价值.     

脑出血患者血清及脑脊液中白细胞介素1β和S-100蛋白水平的变化

目的:探讨脑出血患者血清、脑脊液炎性因子白细胞介素1β水平变化与出血性脑损伤的相关性。方法:选择第三军医大学大坪医院野战外科研究所神经内科2002-05/12住院脑出血患者53例为脑出血组,同期住院的中枢神经系统非器质性疾病患者25例为对照组。脑出血患者急性期(病程7d内)和恢复期(>21d)、对照组于入院后3d内采用双抗体夹心ELISA法测定血清、脑脊液中白细胞介素1β和S-100蛋白水平;采用脑卒中患者临床神经功能缺损程度评分标准评价脑出血患者神经功能缺损情况;采用直线回归法分析脑出血急性期患者血清、脑脊液中白细胞介素1β与S-100蛋白相关性,出血量、神经功能缺失评分与血清、脑脊液中白细胞介素1β、S-100蛋白相关性。结果:78例进入结果分析。①白细胞介素1β水平:血清中脑出血急性期患者高于恢复期和对照组[(3.57±0.53),(2.24±0.18),(2.17±0.17)ng/L,P<0.01];脑脊液中脑出血恢复期患者高于对照组,但低于急性期患者[(2.17±0.12),(2.32±0.17),(2.08±0.13)ng/L,P<0.01]。②S-100蛋白水平:无论血清中还是脑脊液中,脑出血急性期和恢复期患者均高于对照组(P<0.01),脑出血急性期高于恢复期患者(P<0.01)。③相关性分析结果:脑出血急性期白细胞介素1β与S-100蛋白水平呈显著正相关(r血清=0.698,r脑脊液=0.587,P<0.01);患者出血量、神经功能缺损程度与血清、脑脊液中白细胞介素1β和S-100蛋白水平显著相关(P<0.05,0.01)。结论:炎性机制与脑出血继发性损伤有关;S-100蛋白变化可客观反映出血性脑损伤程度。     

S-100蛋白与心脏手术及体外循环后的脑损伤

尽管在麻醉、体外循环 (又称心肺转流 ,ｃａｒ ｄｉｏｐｕｌｍｏｎａｒｙｂｙｐａｓｓ ,ＣＰＢ)和手术技巧等方面取得很大进展 ,但脑损伤仍然是心脏手术病人的主要并发症之一[1,2 ] 。脑损伤的诊断主要依靠病人临床神经系统的检查、ＣＴ和ＭＲＩ等 ,但这些方法不适用于心脏手术后伴有意识障碍、人工通气、血流动力学不稳定及不合作的病人 ,此时通过检测血浆中某种标志物来帮助诊断脑损伤显得很有必要。Ｓ 10 0蛋白是脑损伤的早期标志物之一 ,它可预测脑损伤的程度 ,可以为ＣＰＢ时间的规定、动脉滤器的使用等方面提供参考。近来 ,对成人心脏…     

Relationship between the immune system and the diseases of the central nervous system.

Considering the eventual role of non-specific cell-mediated immune reactions in the pathogenesis of Parkinson's syndrome based on the destruction of dopaminergic cells of the substantia nigra the killer cell activity of patients suffering from this disease has been examined. According to the results the killer cell activity of Parkinson patients is significantly lower in the age group below 60 years as compared to the higher age groups. When comparing the age groups below 60 years, significantly lower activity was measured in the patients than in the controls. Killer cell activity is significantly higher in patients suffering from more severe conditions (Hoehn-Yahr's stage IV-V) when compared to the milder cases. These results suggest the possibility that killer cell-mediated ADCC reaction may play a role in the pathogenesis of the disease. The results of these examinations open new therapeutic perspectives. It may be hoped that, as a result of our increasing knowledge and technical progress in immunology, the damaged immune system could be selectively influenced and target specific immune therapy could be used in the near future by means of for instance inactivations of cytotoxic cells, elimination of antibodies or other immunological methods.     

Viral diseases of the central nervous system

Viral diseases of the central nervous system encompass a wide range of different processes, mainly inflammation affecting the brain (encephalitis), the meninges (meningitis), or a combined meningoencephalitis. The spinal cord can be affected as well (myelitis). Another group of viral-related disorders, sometimes without a clear pathophysiological mechanism disclosed, include post-viral illnesses. All of these groups of diseases are discussed in this article, with an emphasis on their imaging presentation, using magnetic resonance imaging.     

Granulomatous diseases of the central nervous system

Infectious diseases of the central nervous system (CNS), particularly those accompanied by the formation of granulomas, are a constant diagnostic challenge in some specific regions of the world, above all in developing countries. The pattern of image seen on CT or MR scan is the result of the inter-relations between the individual characteristics of the infectious agent and the capacity of each host to mount an appropriate inflammatory response to that specific type of aggression, inside one particular compartment of the CNS. Taking these parameters into account we will discuss the several patterns of image found in parasitic, bacterial, and fungal granulomatous infections.     

Renal elimination of protein S-100beta in pigs with acute encephalopathy

BACKGROUND: Protein S-100beta is an established biochemical marker for cerebral injury in serum. For the further interpretation and possible use of S-100beta serum measurements in acute hepatic encephalopathy, renal elimination of S-100beta was measured in pigs with elevated S-100beta levels due to hepatic encephalopathy. METHODS: Eighteen female Norwegian Landrace pigs were randomly allocated to either hepatic devascularization (n=13) or sham operation (n=5). Repeated samples from the common carotid artery, right renal vein, and urine were simultaneously drawn for S-100beta analysis, using the Sangtec100 Liamat immunoassay. RESULTS: In hepatic devascularized pigs, arterial serum levels of S-100beta increased from 0.96+/-0.04 microg/L (mean +/- SEM) at t = 0h to 1.74+/-0.11 microg/L (mean +/- SEM) at t = 5 h. Urinary excretion increased simultaneously from 8.48+/-3.66 ng/h (mean +/- SEM) to 20.4+/-9.54 ng/h (mean +/- SEM), while renal arterial-venous fluxes for both kidneys increased from 1022+/-404 ng/h (mean +/- SEM) to 2444+/-590 ng/h (mean +/- SEM). CONCLUSIONS: Increased arterial S-100beta levels in pigs with acute hepatic encephalopathy are not a result of decreased renal elimination. The large difference between the renal arterial venous S-100beta concentrations and the urinary excretion of S-100beta indicate that renal metabolism is the major route of elimination.     

Slow virus diseases of the central nervous system

Slow virus diseases are characterized by a long asymptomatic period, often months or years in duration, between the introduction of the infectious agent and the appearance of clinical illness. Two distinct groups cause serious degenerative diseases of the brain and spinal cord. The first to be identified are those caused by "unconventional agents," kuru and Creutzfeldt-Jakob disease. The second category, "conventional virus diseases," include SSPE (subacute sclerosing panencephalitis), PML (progressive multifocal leukoencephalopathy), progressive rubella encephalitis, and HIV encephalopathy. The universal focus on acquired immune deficiency syndrome (AIDS) has stimulated new research on slow viruses. The extreme neurological deficits, the chronic nature of these diseases, and the possible concern with infection control make patients with these diseases a challenge to nursing.     

Microglia in diseases of the central nervous system

Microglia (MG) are enigmatic cells of the central nervous system (CNS). MG are morphologically, antigenically and functionally flexible, and have the potential for mobility and proliferation. MG are professional antigen-presenting cells and constitute part of the local CNS innate immune system, communicating with other immune cells via chemokines, cytokines and growth factors. MG contain several antigenic and functional markers similar to macrophages and dendritic cells (DCs), but also present several differences from DCs. The exact role(s) played by MG in the normal human CNS is the topic of lively debate. MG participate in many reactive processes in the CNS and are therefore an integral part of lesions in a variety of pathologic conditions. It is thought that MG may exacerbate diverse neurological conditions, including viral encephalitis, AIDS, Multiple Sclerosis (MS) and Alzheimer's disease. A recurrent theme is the perpetuation by MG of pathological cycles of monocyte recruitment, activation and cytopathic secretions, and/or auto antigen presentation.