颈动脉支架置入术治疗重度颈动脉狭窄

目的:评价颈动脉支架置入术(CAS)治疗重度颈动脉狭窄的疗效和安全性。方法:对21例重度颈动脉狭窄的患者进行经皮腔内血管成形术和CAS治疗,评价手术效果及其并发症情况。结果:所有患者均顺利完成手术,共置入支架23枚,术后造影证实狭窄程度≤10%,术中出现5例颈动脉窦综合征,2例血管痉挛,1例轻度栓塞,经治疗均恢复良好。随访2～4个月,均未出现与手术血管相关的不良事件。结论:CAS是治疗重度颈动脉狭窄安全、有效的手段,是预防脑梗死的有效措施,而提高操作者本身技巧、加强围手术期的监护能有效地减少并发症和病死率。     

Serum S100 protein could predict altered consciousness in glyphosate or glufosinate poisoning patients

Background: Central nervous system (CNS) complications such as seizures and reduced consciousness are important in glufosinate and may occur in severe glyphosate poisoning. The aim of this study was to assess the possible role of serum S100B protein as a biochemical marker of CNS complications associated with glyphosate or glufosinate poisoning.

Methods: The study enrolled 40 patients (23 glyphosate poisoning and 17 glufosinate poisoning). Altered consciousness and seizure were observed during hospitalization. S100B level was measured with fully automated modular analytic E170 system using electrochemoluminometric immunoassay.

Results: Among 40 patients, neurologic features were observed in 12 patients with a median time to onset of 21.5 (IQR 8.25–24.75) h. Serum S100B concentrations measured on admission were higher in the group with neurologic features than in the group without neurologic features [0.148?μg/L (IQR 0.128–0.248) vs. 0.072?μg/L (IQR 0.047–0.084), p?Conclusions: In our pilot study, S100B was a significant predictor of neurologic complications in patients with glyphosate and glufosinate poisoning. Large prospective cohorts are needed to confirm this finding.     

血液透析患者血液钙结合蛋白S100A12的影响因素及其与动脉硬化关系的研究

目的探讨血液透析患者血液钙结合蛋白S100A12(简称S100A12)水平及其影响因素,研究其与颈动脉粥样硬化之间的关系。方法检测150例血液透析患者血常规(白细胞总数)、肝功能[包括丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(Alb)]、肾功能[包括血肌酐(Cr)、尿素(Urea)]、血脂[包括甘油三酯(TG)、总胆固醇(TC)]、血糖、糖化血红蛋白和S100A12浓度,以100名健康体检者作为正常对照组,采用高分辨二维超声技术测量颈动脉内膜中层厚度(CIMT)。采用Person相关分析S100A12与CIMT的相关性,采用多因素逐步回归分析血浆S100A12浓度的影响因素。结果血液透析组血浆S100A12浓度明显高于正常对照组(P0.05);CIMT与血浆S100A12浓度呈正相关(r=0.4,P0.01)。多因素逐步回归分析显示高白细胞总数、低TC和低Alb是影响血浆S100A12浓度的因素。结论 S100A12与血液透析患者的动脉粥样硬化有关。白细胞总数、TC和Alb能影响血液S100A12浓度。     

Influence of anticoagulants on the measurement of S100B protein in blood

OBJECTIVE: Evaluate anticoagulants influence on plasma S100B levels. DESIGN AND METHODS: Blood were collected from 18 healthy adult subjects using: no anticoagulants, EDTA, heparin, and citrate. S100B levels were determined using LIA-mat assay. RESULTS: Heparin plasma and citrate increased plasma S100B levels (p < 0.001), whereas EDTA had no effect (p = 0.24). Heparin plasma samples were highly (r2 = 0.97, p < 0.001), citrate samples were moderately (r2 = 0.49, p < 0.001), and EDTA samples were not (r2 = 0.22, p = 0.059) correlated with serum samples. CONCLUSIONS: When anticoagulant is required, heparin plasma should be the primary choice for measurement of S100 B levels.     

Influence of anticoagulants on the measurement of S100B protein in blood

OBJECTIVE: Evaluate anticoagulants influence on blood S100B levels. DESIGN AND METHODS: Blood from 18 healthy adult subjects were collected using: no anticoagulants; EDTA; heparin; and citrate. S100B levels were determined using LIA-mat assay. RESULTS: Heparin and citrate increased S100B levels (p<0.001), whereas EDTA had no effect (p=0.24). Heparin samples were highly (r2=0.97, p<0.001), citrate samples were moderately (r2=0.49, p<0.001), and EDTA samples were not (r2=0.22, p=0.059) correlated with serum samples. CONCLUSION: When anticoagulant is required, heparin should be the primary choice.     

缺血性脑卒中患者血清S-100β蛋白变化的临床意义探讨

目的通过测定急性缺血性脑卒中患者血清S-100β蛋白的变化,探讨其与梗死灶大小、神经学状态和神经学预后间的关系。方法采用双抗体夹心酶联免疫吸附试验（ELISA）检测急性缺血性脑卒中患者发病后48h内、第5天、第7天和第14天血清S-100β水平。所有患者于相应时间用美国国立卫生研究院卒中量表（NIHSS）进行神经学状态评估,并于出院时评估神经学功能（BI）。结果患者组各时间点S-100β水平与对照组差异均无统计学意义。S-100β于所有时间点,较大、中等和较小梗死灶组及对照组差异有统计学意义（P〈0．05）,且与相应NIHSS和出院时BI均有非常明显的相关性（P=0．000）。较大梗死灶组血清S-100β水平较高。结论S-100β水平在缺血性脑卒中患者中明显升高,有望成为缺血性脑卒中早期评估、揭示疾病严重程度和评估预后的指标。     

脑梗死患者血浆S100B蛋白测定的临床价值

目的探讨血浆S100B蛋白对脑梗死的诊断价值。方法采用酶联免疫吸附试验(ELISA)对39例脑梗死患者于起病第1、3、7、15天血浆S100B蛋白水平进行了动态测定。结果脑梗死患者血浆S100B蛋白在起病第1、3天显著高于正常对照组(P<0.01),第3天患者S100B蛋白水平上升达峰值,峰值浓度与梗死灶大小及临床预后有显著相关性;第15天下降至与正常对照组相同水平。结论S100B蛋白是一种神经胶质标志蛋白,其水平测定对判断脑梗死患者病变的严重程度、评估预后有重要参考价值。     

急性脑梗死患者血清S-100b蛋白和基质金属蛋白酶-2的含量检测及临床意义

目的观察急性脑梗死(ACI)患者血清S-100b蛋白和基质金属蛋白酶-2(MMP-2)含量的变化,探讨其在ACI发病中的作用及临床意义。方法选取56例ACI病例为患者组,30例健康体检者为对照组。采用ELISA法动态监测血清S-100b蛋白和MMP-2的浓度,并用SPSS17.0统计软件进行统计学分析。结果患者组血清S-100b蛋白和MMP-2水平均明显高于对照组,差异有统计学意义(P<0.05),S-100b蛋白浓度于发病后第3天达高峰,MMP-2浓度于发病后第7天达高峰,之后浓度逐渐降低。S-100b蛋白和MMP-2与脑梗死体积大小和损伤程度存在相关性(P<0.05)。结论 ACI患者脑血清S-100b蛋白和MMP-2浓度能敏感地反映患者梗死体积和神经功能损伤程度,是ACI临床诊断、病情监测和疗效观察的重要参数。     

异丙酚全身麻醉对老年患者血清神经元特异性烯醇化酶、S100B蛋白及认知功能的影响

目的探讨异丙酚全身麻醉对老年患者血清神经元特异性烯醇化酶(NSE)、S100B蛋白水平及认知功能的影响。方法选取择期手术的老年患者121例,随机分为观察组61例和对照组60例,观察组采用异丙酚全身麻醉,对照组吸入异氟烷麻醉。观察2组患者麻醉诱导前(T_0)、手术结束即刻(T_1)、术后1 d(T_2)、术后2 d(T_3)时刻血清S100B蛋白和NSE水平,并观察2组患者术前1 d、术后1 d及术后2 d简易智能状态检查量表(MMSE)评分。结果 2组T_1、T_2时刻NSE水平、血清S100B蛋白均较T_0时刻升高,T_1时刻达到最高,但观察组低于对照组,差异有统计学意义(P0.05,P0.01)。2组T_3时刻恢复至T_0时刻水平,与T_0时刻差异无统计学意义(P0.05)。2组术后1 d MMES评分均下降,但观察组高于对照组,差异有统计学意义(P0.01),2组术后2 d MMES评分均恢复至术前水平,差异无统计学意义(P0.05)。结论异丙酚较异氟烷麻醉对患者术后NSE水平、血清S100B蛋白和术后早期的认知功能影响较小。     

Amniotic fluid levels of S100B protein in normal and trisomy-21 foetuses

Background: The human chromosome 21 has been shown to contain the gene for the β subunit of the S100B protein. The present case-control study was aimed at investigating whether overproduction of S100B protein is detectable in the amniotic fluid of foetuses with trisomy-21. Methods: Measurements of S100B in amniotic fluid samples from 14 pregnant women with trisomy-21 foetuses were compared with those obtained from 182 physiological pregnancies. S100B was measured in the samples using an immunoluminometric assay (LIA-mat Sangtec 100). Results: Our results showed that S100B protein amniotic fluid levels were significantly higher in trisomy-21 foetuses (0.83±0.21 μg/l) than in controls (0.51±0.22 μg/l) (p<0.05). Conclusion: The present finding supports the notion that the expression of S100B is increased in trisomy-21 foetuses; it also constitutes a prerequisite basis for a possible involvement of the protein in pathogenic processes associated with trisomy-21, and/or for its potential employment as a diagnostic tool.     

神经元烯醇化酶和S100蛋白检测在肠道病毒71型感染中的临床意义

目的 研究肠道病毒71型(enterovirus 71,EV71)感染后血清中神经特异性烯醇化酶(NSE)、S100蛋白的变化及其临床意义.方法 采用前瞻性对照研究方法.选择2012年3月1日至2012年10月31日枣庄市妇幼保健院收治的EV71感染患儿176例,依据肠道病毒71型(EV71)感染重症病例临床救治专家共识(2011年版)标准,结合病情轻重将患儿分为3组:普通组62例、重型组65例、危重组49例.另选30例健康体检婴幼儿作为对照组,对照组与普通组、重型组、危重组的年龄和性别差异无统计学意义,具有可比性.患儿于入院后治疗前第1天,治疗后第1天、第2天、第3天分别采空腹静脉血4 mL;健康对照组留取就诊当天空腹静脉血4 mL.分离血浆,采用电化学发光法测定各组血浆中NSE、S100蛋白水平.同时收集入院后24h内的血常规、生化、心肌酶谱、C反应蛋白等临床资料.所有数据采用SPSS 13.0统计软件进行统计处理.计量资料采用均数±标准差((x)±s)表示,多组样本均数比较采用单因素方差分析,两组间比较采用t检验.以P ＜0.05为差异有统计学意义.结果 ①与普通组和对照组比较:重型组及危重组的NSE、S100蛋白含量均明显升高(P＜0.05).②普通组中进展至重型肠道病毒感染者血液中NSE、S100蛋白的水平显著高于病情好转的患儿(P＜0.05).结论 血清NSE、S100蛋白均可以作为判断EV71感染重症的生化标记物,两者的联合检测对于评估病情及判断预后具有一定的临床意义.     

Increased serum levels of S100B are related to the severity of cardiac dysfunction, renal insufficiency and major cardiac events in patients with chronic heart failure

Objective

To investigate the correlations between S100B and the severity of cardiac dysfunction, renal insufficiency (RI) and prognosis in chronic heart failure (CHF).

Method

Serum levels of S100B, TNF-α, high sensitivity CRP and NT-proBNP were determined in CHF patients with (n = 96) and without RI (n = 146). Patients with RI only (n = 62) and control subjects (n = 64) served for comparison. Patients were followed up for one year.

Results

S100B levels were higher in CHF patients with a further elevation in those with RI (P < 0.01). Serum S100B levels correlated with left ventricular ejection fraction, left ventricular end-diastolic volume and NT-proBNP in CHF patients, and eGFR in patients with RI (all P < 0.05). Increased S100B levels were associated with major cardiac events (MCE), and were independently associated with the presence of CHF (all P < 0.05).

Conclusion

Increased serum S100B levels were associated with the severity of cardiac dysfunction, RI and an adverse prognosis in CHF patients. It represents an independent risk factor for CHF.     

Nitric oxide test during cardiac catheterization decreases the serum concentrations of S100B protein in adult patients with idiopathic pulmonary hypertension

Objective. Cardiac catheterization (CC) is a life‐threatening procedure in adult patients. Complicated by idiopathic arterial pulmonary hypertension (IPAH), there is a potential risk of central nervous system (CNS) damage. We measured serum levels of a well‐established brain damage marker, namely S100B, collected before, during and after CC in adult patients in whom the nitric oxide (NO) test had been performed. Material and methods. In 12 adult patients who had undergone CC for IPAH diagnosis, we recorded clinical and standard monitoring procedures (laboratory variables and echocardiographic patterns) and serum concentrations of S100B before (time 0), during (time 1) and after the NO test (time 2) and at 24?h after (time 3) the procedure in samples obtained from the systemic and pulmonary circulation. Patients were subdivided into NO test responders (n = 6) and non‐responders (n = 6). Neurological evaluation was performed at admission and at discharge from hospital. Results. Adult patients subjected to CC showed no overt neurological injury at discharge from hospital. No significant differences (p>0.05 for all) in S100B serum levels between groups at times 0, 1 and 3 have been shown independently from the sampling site. It was noteworthy that the concentration of protein in the responders group at time 2 was significantly decreased (p<0.05, for all) compared to the responder group and to baseline values. A significant correlation was found between arterial oxygen partial pressure and individual S100B concentration in the pulmonary and systemic bloodstream in the entire study group (R = ?0.66 and R = ?0.71, respectively; p<0.05, for both). Conclusions. The data suggest that S100B protein assessment, as well as the NO test, may be useful when monitoring possible CNS damage during CC in patients with IPAH, and may also be valuable in relation to brain functions, especially when performed as an emergency procedure in severely hypoxic patients.     

脑梗死患者血清高敏C反应蛋白与颈总动脉内中膜厚度的关系探讨

目的探讨脑梗死患者高敏C反应蛋白（hs-CRP）与颈总动脉内中膜厚度（IMT）的关系。方法将207例脑梗死患者按其IMT分成3个亚组（Ⅰ组：IMT≤0.92 mm;Ⅱ组：0.92 mm〈IMT≤2.00 mm;Ⅲ组：IMT〉2.00 mm）;根据是否存在颈总动脉硬化分为颈动脉硬化组和非颈动脉硬化组。将101名健康体检者作为对照组,测定各组空腹血清hs-CRP,并进行比较分析。结果脑梗死组血清hs-CRP水平明显高于对照组（P〈0.01）;脑梗死患者不同IMT组的hs-CRP水平存在差异,并随着IMT的增加而升高（P〈0.05、P〈0.01）;颈动脉硬化组的hs-CRP水平明显高于非颈动脉硬化组（P=0.003）。hs-CRP与IMT呈正相关（r=0.239,P=0.028）。结论 hs-CRP可作为反映颈动脉硬化发生和脑梗死危险性的指标。     

急性胰腺炎患者血清钙结合蛋白S100A12的表达及其临床意义

目的分析血清钙结合蛋白S100A12表达水平与急性胰腺炎(AP)患者病情间的相关性,以期为临床AP病情判断提供简单可靠的手段。方法选择2015年1月至2016年1月收治的AP患者68例,确诊后完善相关检查,采用修正后的CT严重指数(MCTSI)对其病情严重程度进行分级判定,所有患者均检测血清钙结合蛋白S100A12。比较不同病情分级患者S100A12水平差异。根据不同病情程度患者的S100A12数据制作ROC曲线,将曲线拐点作为S100A12判断病情严重程度的临界值,以MCTSI判断结果为参照,计算S100A12判断AP患者病情分级的灵敏度、特异度和准确度,评价S100A12在判断胰腺炎病情的临床价值。结果不同MCTSI分级的患者,其S100A12表达水平从Ⅰ级至Ⅲ级逐渐升高,差异有统计学意义(P0.05)。ROC曲线结果显示,Ⅰ级至Ⅲ级S100A12临床限值分别为26~80、81~260、260ng/mL。S100A12判断Ⅰ级、Ⅱ级、Ⅲ级的灵敏度分别为88.89%、94.12%、80.00%,特异度分别为75.00%、94.12%、96.55%,准确度分别为82.35%、94.12%、94.12%。结论 AP患者血清钙结合蛋白S100A12对判断患者病情严重程度方面与MCTSI较为一致。     

头颅MRI、振幅整合脑电图及血清S100B、CRP水平在早产儿脑病中的研究进展

早产儿脑病是以脑白质受损为主的一类早产儿脑损伤,是近十年来人们在既往对早产儿脑损伤认识基础上提出的新概念.早产儿脑病发生率逐年上升,常有严重的后遗症,严重影响早产儿的生存质量,给家庭与社会带来极其沉重的负担.目前临床上对于早产儿脑损伤没有可靠的诊疗方法,因此,早期诊断、早期治疗是早产儿脑病的研究热点.为了更好地了解早产...     

薯蓣皂甙对老年类风湿性关节炎合并脑梗死患者血清脂联素、肿瘤坏死因子α和S100B水平的影响

目的 评价薯蓣皂甙对老年类风湿性关节炎合并脑梗死患者体质量指数及血清脂联素、肿瘤坏死因子α和血清S100B浓度的变化及其临床意义.方法 选取2006年9月至2010年9月长治市人民医院神经内科与康复科和绍兴医学院附属医院内科就诊,具有老年类风湿性关节炎合并脑梗死患者100例(男55例,女45例),平均年龄57岁.将100例患者随机分为两组,常规老年类风湿性关节炎组(50例)接受常规药物治疗,薯蓣皂甙组(50例)采用常规药物治疗基础上加用薯蓣皂甙片80 mg,3次/d;另设40例中年单纯性类风湿关节炎患者作为对照(常规对照组),所有患者在治疗前后均常规测定体质量指数、血糖、血脂分析及胰岛素抵抗指数,以及检测血清脂联素、肿瘤坏死因子α和血清S100B浓度变化.结果 薯蓣皂甙组及常规老年类风湿性关节炎组血清脂联素浓度及体质量指数较常规对照组患者明显降低[分别为(7.2±1.4)、(7.3±1.4)、(18.1±3.5)μg/L,F=17.057,P＜0.01;(18.9±2.4)、(19.0±1.9)、(21.8±1.8)kg/m2,F=6.147,P＜0.01];肿瘤坏死因子α及S100B浓度增加[分别为(89.0±25.3)、(88.0±24.2)、(74.0±21.0) ng/L,F=3.292,P＜0.05; (0.102±0.051)、(0.101±0.045)、(0.092±0.031)μg/L,F=2.792,P＜0.05].血清脂联素与肿瘤坏死因子α及S100B呈负相关(r=-0.46,-0.52;P均＜0.01);血清脂联素与体质量指数呈正相关(r=0.44,P＜0.01).薯蓣皂甙组治疗6个月分别与常规对照组比较,血清脂联素浓度提高[分别为(12.2±2.9)、(7.8±1.8)、(18.0±4.3) μg/L,F=6.480,P＜0.01],肿瘤坏死因子α及血清S100B浓度明显降低[分别为(72.0±21.0)、(82.0±23.0)、(68.0±20.0) ng/L,F=3.065,P＜0.05; (0.092±0.021)、(0.099±0.031)、(0.091±0.029) μg/L,F=3.030,P＜0.05],而且改善脑梗死患者预后明显优于常规老年类风湿性关节炎组(x2=11.97,P＜0.01).结论 口服薯蓣皂甙片可改善老年类风湿性关节炎合并脑梗死患者预后,提高血清脂联素浓度及显著降低肿瘤坏死因子α及血清S100B浓度,体质量指数也有不同程度的增加.     

动态观察急性脑梗死患者血清S100B蛋白的表达与神经功能缺损程度的关系

目的：研究急性脑梗死（ACI）患者血清特异性神经元烯醇化酶（NSE）与内皮素（ET ）以及S100B蛋白的表达,在急性期变化中同神经功能缺损程度之间的关系。方法回顾性分析2008年5月至2012年5月治疗的90例ACI患者临床资料（观察组）,以及同时期治疗的62例非神经系统类疾病患者临床资料（对照组）,对比分析两组患者神经功能缺损程度以及血清 NSE、ET、S100B蛋白的表达情况。结果观察组患者血清的 NSE、ET、S100B蛋白的表达同对照组相比,均呈不同程度的增高,差异有统计学意义（ P＜0．01）;观察组不同神经功能缺损的评分分型的患者血清NSE、ET 以及S100B蛋白的表达,差异有统计学意义（P＜0．01）。结论 ACI患者血清的NSE、ET以及S100B蛋白表达,与神经功能缺损程度具有密切关系,当神经功能缺损的程度越重,患者血清的NSE、ET以及S100B蛋白的水平就越高,因此三项指标能够作为ACI患者脑损伤的一种敏感标记物;可以作为对患者病情进行判断、对预后进行评估的重要指标,并且非常适合不能够予以影像学诊断的ACI患者。     

血塞通对急性脑梗死患者外周血白细胞和血清S-100B蛋白的影响

目的观察血塞通对急性脑梗死(ACI)患者外周血白细胞(WBC)及血清S-100B蛋白含量的影响,探讨血塞通治疗脑梗死可能的作用机制。方法 118例ACI患者随机分成血塞通治疗组(A组)和对照组(B组)。B组予以常规的脱水、护脑治疗和丹参注射液治疗,A组在上述治疗基础上应用血塞通静脉注射。两组均于入院后6h、3d、8d、15d、30d等各时间点测定外周血WBC以及血清S-100B蛋白含量,并与10名健康成年人作为正常对照组比较,观察治疗后两组患者外周血WBC以及血清S-100B蛋白含量变化。结果①ACI患者外周血WBC计数以及血清S-100B蛋白含量明显高于正常对照组,差异有统计学意义(P<0.01),且增高的程度与患者临床神经功能缺损程度评分密切相关,评分越高WBC和S-100B蛋白含量越高。②ACI患者外周血WBC以及血清S-100B蛋白含量呈正相关(r=0.6837,P<0.01)。③30d后两组ACI患者外周血WBC以及血清S-100B蛋白含量均降低,但A组降低更明显,与B组比较具有显著性差异(P<0.05),而且出院时A组患者的疗效也优于B组。结论血塞通能降低ACI患者的外周血WBC以及血清S-100B蛋白含量,可能与血塞通减轻外周血WBC和S-100B蛋白介导的损伤性脑细胞炎症反应有关。