颅脑损伤患者血清S-100B蛋白浓度的动态变化及其临床意义

目的通过对血清S-100B蛋白浓度的动态检测，探讨其在颅脑损伤严重程度分型及预后评估中的意义。方法对120例颅脑损伤患者按照格拉斯哥评分（GCS评分）分为轻型、中型、重型3组，用酶联免疫吸附法动态检测伤后6h内及伤后第2-6天患者血清S-100B蛋白浓度．结合临床表现及伤后2周格拉斯哥预后评分（GOS评分）进行比较分析。结果颅脑损伤组患者血清S-100B蛋白浓度明显高于正常对照组（P〈0．05）：轻型、中型、重型颅脑损伤组患者之间血清S-100B蛋白浓度存在显著性差异（P〈0．05）；颅脑损伤早期（6小时内）血清S-100B蛋白浓度显著升高．轻型颅脑损伤组多在1～2内下降，中型颅脑损伤组多在2～3内下降，重型颅脑损伤组持续保持较高水平；预后良好组与预后恶劣组之间血清S-100B蛋白浓度存在显著性差异（P〈0．05）。结论血清S-100B蛋白浓度是判断颅脑损伤严重程度及预后的一种客观生物学指标，     

S100B在成人颅脑外伤患者术后颅内感染和预后判断中的应用

目的探究颅脑外伤患者血S100B水平测定在判断术后颅内感染和预后方面的价值。方法选择本院自2012年1月至2014年1月手术治疗的成人颅脑外伤患者共160例,入院即刻及第1~7天每天抽血取样测定血S100水平。根据GCS评分分为≤8分组66例,8分组94例;按照住院期间是否并发颅内感染分为感染组15例,未感染组145例;依据术后12月GOS评分分为预后良好组(GOS 4-5)54例和预后不良组(GOS 1-3)。比较分析各组间S100水平差异。结果 GCS≤8分组入院时血S100B水平显著高于GCS8分组(P0.001);从入院第3天开始,感染组S100B水平较未感染组出现显著性升高(P0.001);从入院时开始,预后不良组的S100水平显著高于预后良好组(p0.001)。结论 S100B是反映脑组织损伤程度的敏感指标,与患者入院时的病情严重程度相平行,对于预测术后感染、临床预后具有一定的指导意义。     

血清NSE、S100B蛋白和颅脑损伤程度及预后的相关性研究

目的探讨神经元特异性烯醇化酶(NSE)、S100B蛋白在颅脑损伤患者血清的动态变化和患者预后的相关性。方法采用酶联免疫吸附法(ELISA)检测65例颅脑损伤患者伤后12小时、1～7天、10天、14天血清NSE、S100B蛋白并分析各自变化趋势;以第1～3天血清平均浓度分析2种指标和损伤程度的关系;绘制受试者工作特征(ROC)曲线评价第1～3天平均血清NSE和S100B蛋白浓度对预后的预测价值。结果预后不良组血清NSE、S100B蛋白水平均显著高于预后良好组(P0.05)。第1～3天NSE、S100B蛋白血清平均浓度,特重型组患者显著高于中型和重型组、重型组显著高于中型组(P0.05)。血清NSE、S100B蛋白的曲线下面积分别为0.850(95%CI:0.792～0.909)和0.837(95%CI:0.783～0.892);NSE、S100B蛋白联合检测曲线时曲线下面积为0.903 (95%CI:0.861～0.946),可显著提高预后不良的诊断敏感度至84.3%、特异度至81.7(P0.05)。结论颅脑损伤后血清NSE、S100B蛋白升高,可辅助判断颅脑损伤严重程度,2种标记物水平对评估颅脑损伤预后具有较号的特异性和敏感性,联合检测能提高预测性能。     

人高迁移率族蛋白B1、晚期糖基化终产物受体和C反应蛋白与脑外伤术后肺部感染严重程度的相关性及对预后的评估价值

目的探讨人高迁移率族蛋白B1（HMGB-1）、晚期糖基化终产物受体（RAGE）、C反应蛋白（CRP）与脑外伤术后肺部感染严重程度的相关性及对预后的评估价值。 方法前瞻性选取2016年5月至2018年5月于长治医学院附属和平医院接受治疗的182例脑外伤术后肺部感染者,根据肺部感染CURB-65评分系统标准将患者分为轻度组（74例）、中度组（60例）和重度组（48例）,并根据术后30 d临床结局分为生存组（151例）和死亡组（31例）。比较不同感染程度患者血清HMGB-1、RAGE、CRP水平并分析与肺部感染严重程度的相关性。通过Logistic回归分析明确影响患者死亡的危险因素,以受试者工作特征曲线（ROC）评价HMGB-1、RAGE和CRP对脑外伤术后肺部感染者死亡的预测价值。 结果重度组患者HMGB-1水平为（10.22 ± 2.35）μg/L,分别高于中、轻度组[（3.89 ± 1.01）μg/L和（2.00 ± 0.40）μg/L],差异有统计学意义（t = 18.821、29.502,P均< 0.001）;重度组患者RAGE水平为（9.01 ± 2.05）ng/L,分别高于中、轻度组患者[（5.89 ± 1.20）ng/L和（2.12 ± 0.22）ng/L],差异有统计学意义（t = 9.870、28.722,P均< 0.001）;重度组患者CRP水平为（50.33 ± 10.32）mg/L,分别高于中、轻度组患者[（32.33 ± 8.52）mg/L和（15.20 ± 3.52）mg/L],差异有统计学意义（t = 9.930、27.010,P均< 0.001）。中度组患者血清HMGB-1、RAGE和CRP水平均高于轻度组（t = 14.744、26.504、15.729,P均< 0.001）;血清HMGB-1、RAGE和CRP水平均与肺部感染CURB-65评分呈正相关（r = 0.696、0.763、0.851,P均< 0.001）。182例患者的病死率为17.03%（31/182）。死亡组患者呼吸机应用、气管切开、低蛋白血症占比均显著高于生存组,年龄、HMGB-1、RAGE、CRP、降钙素原（PCT）水平均高于生存组（P均< 0.05）。Logistic回归分析年龄、呼吸机应用、气管切开、低蛋白血症、HMGB-1、RAGE、CRP和PCT均为导致患者死亡的危险因素（OR = 2.016、2.423、2.252、1.853、2.606、2.199、1.919、1.904,P均< 0.05）。ROC曲线分析显示血清HMGB-1、RAGE和CRP预测脑外伤术后肺部感染者死亡的敏感性分别为78.02%、82.42%和85.16%,特异度分别为56.04%、69.78%和71.98%,曲线下面积（AUC）分别为0.756、0.801和0.882。 结论血清HMGB-1、RAGE和CRP水平与脑外伤术后肺部感染严重程度呈正相关,且均为导致患者死亡的危险因素,对于预测患者的死亡有较高的临床价值。     

硫酸镁对急性重型颅脑损伤患者血清S-100B蛋白浓度的影响

目的通过动态观察硫酸镁对急性重型颅脑损伤患者血清S-100B蛋白浓度的影响，进一步探讨硫酸镁在急性重型颅脑损伤治疗中的作用。方法将120例急性重型颅脑损伤患者随机分为硫酸镁组和常规组。硫酸镁组在常规治疗的基础上，予25％硫酸镁8ml用生理盐水稀释至100ml匀速静脉推注，时间为15分钟。然后将25％硫酸镁30ml加入5％葡萄糖500ml中用24小时缓慢静脉滴注，输液泵控制输液速度，连续用7天。所有患者于入院6小时内，入院后第2、3、4、5、6天动态检测血清S-100B蛋白浓度。3个月后对患者进行GOS评估。结果硫酸镁组和常规组血清S-100B蛋白浓度明显高于正常对照组（P〈0，05）；硫酸镁组血清S-100B蛋白浓度明显低于常规组（P〈0．05）；硫酸镁能够改善急性熏型颅脑损伤患者的预后。结论急性重型颅脑损伤患者血清S-100B蛋白浓度明显升高，早期应用硫酸镁能显著降低患者血清S-100B蛋白浓度，保护神经功能．改善预后。     

丙泊酚麻醉对急性颅脑外伤手术患者血清S100B的影响

目的研究急性颅脑外伤手术前和手术期间丙泊酚对血清S100B的影响,以评价丙泊酚的脑保护作用。方法急症颅脑外伤手术患者30例。随机分为丙泊酚（A）组和异氟醚（B）组,每组15例。另10例泌尿系统手术的非颅脑损伤患者的血清作空白对照（C）组。酶联免疫吸附法测定C组及A、B组颅脑手术前、手术开始2h、手术结束时血清S100B含量。对急症颅脑外伤手术患者进行格拉斯哥（Glasgow）评分。结果A、B组患者手术前S100B显著高于C组（P〈0．01）;Glasgow评分越低的患者术前S100B越高（r=-0．446,P〈0．05）。手术结束时A组S100B显著低于B组（P〈0．05）。开颅手术2h和手术结束时两组S100B均较术前有升高。结论急性颅脑外伤时患者血清S100B升高,Glasgow评分越低,血清的S100B浓度也越高。提示临床剂量丙泊酚可以抑制血清S100B的升高,减轻继发性脑损害,具有脑保护作用。     

血必净对重型颅脑损伤患者血清S100B蛋白水平的影响

目的:探讨血必净对重型颅脑损伤患者血清S100B蛋白水平的影响及其临床意义.方法:重型颅脑损伤患者48例(GCS≤8分),对照组26例常规治疗,实验组22例常规治疗早期(≤3h)辅以血必净治疗,24h、3d及7d后,ELISA法检测两组血清S100B蛋白水平.结果:实验组治疗24h、3d及7d后,血清S100B蛋白水平和对照组比较,有统计学差异(P<0.05).结论:血曲净可明显降低重型颅脑损伤患者血清S100B蛋白水平,降低全身和局部的炎症反应程度,发挥神经保护作用.     

急性颅脑损伤患者血浆标记物的筛选和临床应用

目的研究急性颅脑损伤患者血清标志物与预后的关系。方法 100例急性颅脑损伤患者进入研究,记录年龄,GCS评分,瞳孔和头颅CT的Rotterdam评分;检测血清S100钙结合蛋白B(S100B),神经元特异性烯醇化酶(NSE),和肽素(Copeptin)和胶质纤维酸性蛋白(GFAP)浓度;预后指标:外伤后6个月GOS评分。结果血清S100B(Z=7.87;P0.01)和NSE(Z=7.37;P0.01)浓度与急性颅脑损伤预后有关,分类和回归树分析显示以S100B、瞳孔情况、肺栓塞、NSE和CRP预测因子建立的树状预测模型,预测预后的总准确率达87%。结论急性颅脑损伤患者血清S100B和NSE水平与预后相关,与临床指标结合可准确预测预后。     

外周血可溶性Fas蛋白及其配体、髓过氧化物酶水平对重症肺炎患儿预后不良的预测价值

目的观察重症肺炎患儿外周血可溶性Fas蛋白（sFas）、可溶性Fas蛋白配体（sFasL）和髓过氧化物酶（MPO）水平变化,并探讨三者对重症肺炎预后不良的预测价值。 方法选取四川中医药高等专科学校绵阳富临医院2016年2月至2020年5月收治的182例重症肺炎、196例轻症肺炎患儿和178例健康儿童,分别为重症组、轻症组和对照组;重症组患儿再根据预后分为预后不良组（29例）和预后良好组（153例）。采用单因素方差分析比较重症组、轻症组治疗前和对照组外周血sFas、sFasL和MPO水平;采用单因素和多因素Logistic回归分析重症组患儿预后不良的影响因素,采用受试者工作特征（ROC）曲线评价外周血sFas、sFasL和MPO水平以及联合指标预测重症组患儿预后不良的价值。 结果三组研究对象的性别、年龄和体重,重症组与轻症组患儿病原微生物分布、肺炎分期差异均无统计学意义（P均> 0.05）。重症组患儿治疗前外周血sFas、sFasL和MPO水平分别为（104.63 ± 19.75）ng/L、（1 062.36 ± 179.85）ng/L和（1 020.26 ± 59.71）U/L,轻症组患儿分别为（80.52 ± 13.66）ng/L、（703.57 ± 127.66）ng/L和（796.75 ± 43.02）U/L,对照组儿童分别为（58.78 ± 10.16）ng/L、（577.83 ± 121.22）ng/L和（632.59 ± 38.71）U/L;重症组和轻症组患儿以上3个指标水平均高于对照组（sFas：重症组 vs.对照组：t = 27.605、P < 0.001;轻症组vs.对照组：t = 17.322、P < 0.001;sFasL：重症组 vs.对照组：t = 29.908、P < 0.001,轻症组vs.对照组：t = 9.744、P < 0.001;MPO：重症组 vs.对照组：t = 71.920、P < 0.001;轻症组vs.对照组：t = 38.647、P < 0.001）,重症组患儿以上3个指标水平均显著高于轻症组（t = 13.885、22.488、41.973,P均< 0.001）。重症组患儿预后不良发生率为15.93%（29/182）。预后不良组患儿双重/多重感染占比（χ² = 12.081、P = 0.001）、多肺叶感染占比（χ² = 32.378、P < 0.001）和外周血白细胞计数（WBC）（t = 6.432、P < 0.001）、中性粒细胞百分比（N%）（t = 3.658、P = 0.001）、C-反应蛋白（CRP）（t = 19.415、P < 0.001）、降钙素原（PCT）（t = 26.101、P < 0.001）、sFas（t = 13.717、P < 0.001）、sFasL（t = 5.357、P < 0.001）和MPO（t = 5.435,P < 0.001）水平均显著高于预后良好组患儿;多因素Logistic回归分析显示以上指标均为重症组患儿预后不良的危险因素,差异均有统计学意义（OR = 5.969、95%CI：4.857~6.304、P = 0.029,OR = 7.485、95%CI：6.785~8.126、P = 0.014,OR = 5.332、95%CI：4.593~5.567、P = 0.010,OR = 4.959、95%CI：4.246~5.337、P = 0.015,OR = 5.143、95%CI：4.879~5.695、P = 0.003,OR = 6.126、95%CI：5.630~6.558、P = 0.008,OR = 8.325、95%CI：6.452~9.902、P = 0.005,OR = 8.469、95%CI：7.879~8.653、P = 0.001,OR = 9.132、95%CI：8.882~9.594,P = 0.003）。外周血sFas、sFasL和MPO水平预测重症组预后不良的Cut-off值分别为125.07 ng/L、1 171.21 ng/L和1 053.04 U/L;sFas、sFasL和MPO以及3个指标联合预测的曲线下面积（AUC）分别为0.875、0.890、0.897和0.955,3个指标联合预测AUC均显著高于sFas、sFasL、MPO水平单独预测,差异均有统计学意义（Z = 5.693、P = 0.005,Z = 5.192、P = 0.007,Z = 4.982、P = 0.009）。 结论重症肺炎患儿外周血sFas、sFasL和MPO水平均偏高,且在预后不良重症患儿中水平均更高,其联合应用可预测患儿不良预后。     

结直肠癌术后发生腹腔感染患者血清CRP/ALB和肝素结合蛋白的表达及相关影响因素分析

目的：探讨结直肠癌术后发生腹腔感染患者血清C反应蛋白/白蛋白（CRP/ALB）比值、肝素结合蛋白的表达及相关影响因素。方法：选取我科2018年6月至2021年7月收治的213例行结直肠癌手术患者作为研究对象，其中术后发生腹腔感染者25例设为观察组，未发生腹腔感染者188例设为对照组，比较2组患者血清CRP/ALB、肝素结合蛋白水平，分析发生腹腔感染的影响因素。结果：观察组患者血清CRP/ALB、肝素结合蛋白水平明显高于对照组（P <0.05）；多因素Logistic分析结果表明，合并糖尿病、肿瘤分期、手术时间、出血量、切口长度、引流管置管时间、术后发生吻合口漏是术后发生腹腔感染的影响因素（P <0.05）。结论：结直肠癌术后发生腹腔感染患者血清CRP/ALB、肝素结合蛋白水平均有明显升高，糖尿病、手术时间、切口长度、术后是否发生吻合口漏等因素均会影响患者术后发生腹腔感染。     

Effects of head and extracranial injuries on serum protein S100B levels in trauma patients

BACKGROUND: Serum protein S100B determinations have been recently suggested as markers of traumatic brain injury. However, little is known about the effects of extracranial injuries on S100B levels in trauma patients. METHODS: We studied 224 patients with head trauma (54 of whom also had extracranial injuries), 155 patients with various types of extracranial injuries, and 8 healthy pilots exposed to high Gz forces. The head trauma patients had either no brain injury (n = 35), mild brain injury (n = 165), or moderate to severe brain injury (n = 24). The extracranial injuries were divided into small and large injuries. Serum protein S100B levels were determined from samples taken within 6 hours after the trauma event. RESULTS: The head trauma patients had a significantly higher median S100B (0.17 microg/L) than the patients with extracranial injuries (0.07 microg/L) (p < 0.001). Serum S100B levels also correlated with the severity of brain injury (p < 0.001), the highest values occurring in the patients with moderate to severe brain injury (1.27 microg/L). However, large extracranial injuries also elevated S100B levels (0.35 microg/L), whereas small extracranial injuries in the absence of head trauma did not significantly affect S100B levels (0.07 microg/L). Above the cutoff level of 0.13 microg/L, there were 61% of the head trauma patients and 26% of those with extracranial injuries (Pearson chi test, p < 0.001). However, only 4% of the patients with purely extracranial injuries had a concentration of S100B above the cutoff level of 0.50 microg/L, whereas the head trauma patients with moderate to severe brain injury exceeded this cutoff in 67% of the cases. Exposure to high Gz forces did not influence serum S100B levels in healthy individuals. CONCLUSION: We conclude that serum S100B is a sensitive marker of brain injury, which correlates with the severity of the injury. Large extracranial injuries also elevate S100B levels. However, S100B has a high negative predictive power, and the finding of a normal S100B value shortly after trauma should thus exclude significant brain injury with a high accuracy.     

Cytokine and S100B levels in paediatric patients undergoing corrective cardiac surgery with or without total circulatory arrest.

OBJECTIVES: Neurological damage following cardiopulmonary bypass (CPB) is difficult to objectively evaluate in infants. In adults, serum elevations of astroglial S100B correlate with proven brain injury independent of operative temperature. The deleterious effects of inflammatory cytokines, generated during CPB, on the brain have not been studied in infants using S100B as a marker for cerebral injury. METHODS: Twelve neonates, weighing 3.3 +/- 0.2 kg (total circulatory arrest group (TCA)) and 12 infants weighing 7.0 +/- 1.0 kg (cardiopulmonary bypass group (CPB)) underwent corrective cardiac surgery for various pathologies. Serial blood samples on induction, at the end of CPB, 30 min, 2 h and 24 h after the administration of protamine, were taken. The resultant plasma was frozen to -80 degrees C and stored for batch analysis. Cytokines were measured using ELISAs and S100B using a luminometric assay. RESULTS: The TCA group were younger and experienced a longer perfusion time than the CPB group (137 +/- 8 vs. 113 +/- 7, P = 0.04). The mean TCA time was 23 +/- 4 min. The TCA group had significantly higher levels of IL-6 (P = 0.001), IL-8 (P = 0.005) and S100B (P = 0.002) at 24 h. C5b-9 levels were significantly lower in the TCA group: end of CPB (P = 0.001), 30 min (P < 0.001), 2 h (P = 0.002). There was a weak, but significant correlation between IL-6 levels at the end of CPB and S100B levels 2 h later (r = 0.55, P = 0.03). Long extubation times were associated with high 24-h S100B levels (r = 0.52, P = 0.01). CONCLUSIONS: (1) The TCA group have prolonged rises of IL-6, IL-8 and S100B. (2) The TCA group generates significantly lower complement. (3) Astroglial injury, seen after surgery, may, in part, be cytokine mediated.     

Dynamic change of serum protein S100b and its clinical significance in patients with traumatic brain injury

Withgradualclarificationofmolecularconstitutionandbiologicalactivities,studiesinrecentdecadeshaveprovedthatproteinS100b,asaneurobiochemicalmarker,hasbecomeaspecificproteinthatcanbestreflectbraininjuryseverityand prognosis.1Inourstudy,wehavediscussedthe associationofserumS100bproteinwithtraumaticbrain injuryaswellasitsclinicalsignificancethrough observingdynamicchangesofserumS100bproteinby ELISA.METHODS Materials Atotalof102casesofbraininjuryadmittedinto traumaticsurgerydepartmentofourhos…     

Postoperative course of S-100B protein and neuron-specific enolase in patients after implantation of continuous and pulsatile flow lvads

BACKGROUND: In the early post-operative period after implantation of a continuous flow left ventricular assist device (LVAD) a non-pulsatile flow occurs. We compared the post-operative time-courses of protein S-100B (S100B) and neuron-specific enolase (NSE) as biochemical markers of brain injury in patients after implantation of a continuous flow LVAD and patients receiving a pulsatile flow LVAD. METHODS: Since 1998 the continuous flow DeBakey VAD has been implanted in 8 patients at our institution. For comparison purposes, a group of 7 consecutive patients in whom a pulsatile Novacor N100 LVAD was implanted were investigated. In both groups cardiopulmonary bypass (CPB) with cardiotomy suction was used. S100B and NSE were measured in serum pre-operatively, 4 hours after CPB, and on days 1, 3, 7, and 14 after implantation of the LVAD. A neurologic examination was performed pre-operatively and post-operatively on days 3 and 14. RESULTS: No differences were found between groups in pre-operative characteristics. The analysis of variance with repeated measurements for S-100B and NSE showed significant time effects (p = 0.004, p = 0.009, respectively) but no group effects (p = 0.06, p = 0.26, respectively) and no interaction between groups and time (p = 0.12, p = 0.48, respectively). The pre-operative serum level of S100B was significantly higher (p = 0.03) in the DeBakey VAD group. The pre-operative serum level of NSE was similar in the 2 groups (p = 0.7). In both groups there was a significant increase of S100B and NSE immediately after surgery (S100B: p = 0.006, p = 0.019; NSE: p = 0.01, p = 0.001). The values returned to pre-operative levels in the DeBakey VAD group on day 1 after implantation and in the Novacor group for S100B on day 3 and NSE on day 1. Post-operatively the mean values of S100B and NSE in the DeBakey VAD group compared with the Novacor group were significantly elevated only on day 3 (p = 0.005, p = 0.023).No neurologic complications were noted in patients with a continuous flow LVAD, whereas in the pulsatile LVAD group 2 patients presented neurologic abnormalities during the study period. CONCLUSIONS: The similar course of biochemical markers of brain damage in both groups may indicate that the non-pulsatile flow in the early post-operative period does not lead to increased brain injury or permeability of the brain blood barrier.Elevated levels of S100B and NSE in the post-operative period can be used as diagnostic markers of brain injury in patients after implantation of both types of LVAD.     

流行性感冒患者血清高尔基体蛋白73水平变化

目的探讨血清高尔基体蛋白73（GP73）水平在流行性感冒（流感）患者中的变化以及对预后转归的影响。 方法收集2017年7月至2018年10月于中国人民解放军联勤保障部队第九一O医院住院的流行性感冒患者83例（流感患者组），选择同期健康体检者50例为对照组。采用ELISA法检测血清GP73浓度，观察流感患者入院发热时、退热后及出院随访1个月时血清GP73水平、降钙素原（PCT）和白细胞介素-6（IL-6）的变化。血清GP73、PCT和IL-6水平采用中位数（四分位间距）表示。采用方差分析进行组间差异比较，治疗前后各指标变化采用Wilcoxon检验，变量间相关性分析采用线性回归和Spearman秩相关系数（r）进行评价。 结果83例流感患者检出A型流感病毒72例（86.75%），B型流感病毒11例（13.25%）。72例A型流感病毒中，检出H3亚型65例（90.28%），H1亚型7例（9.72%），未检出H5、H7、H9等其他亚型流感病毒。流感患者入院发热时血清GP73浓度为137.7（100.6，179.4）ng/ml，显著高于健康体检者[32.9（23.0，52.25）ng/ml]，差异有统计学意义（F = 12.30、P < 0.001）。流感患者入院发热时IL-6浓度为[12.98（11.28，19.80）] ng/ml，显著高于健康体检者[1.52（1.31，1.72）ng/ml]，差异有统计学意义（F = 15.61、P < 0.001）；血清PCT含量为0.032（0.022，0.082）ng/ml略高于健康体检者[0.025 ng/ml（0.019，0.035）ng/ml]，但差异无统计学意义（F = 1.52、P = 0.253）。流感患者退热后血清GP73含量快速下降，退热后及随访1个月血清GP73含量分别为80.13（60.20，96.54）ng/ml和46.65（40.47，55.59）ng/ml，与流感患者入院发热时血清GP73浓度[137.7（100.6，179.4）ng/ml]比较，差异均具有统计学意义（Z退热后vs.发热时=－9.46、P < 0.001；Z随访1个月vs.发热时=－15.23、P < 0.001）。 结论流感患者发热时血清GP73浓度显著升高，退热后快速下降。血清GP73可能作为急性期炎症损伤或修复的快速反应蛋白，参与流感患者炎症损伤和修复过程。     

A glial-derived protein,S100B,in neonates and infants with congenital heart disease: evidence for preexisting neurologic injury

The glial-derived protein S100B is a serum marker of cerebral ischemia and correlates with negative neurological outcome after cardiopulmonary bypass (CPB) in adults. We sought to characterize the S100B release pattern before and after CPB in neonates and infants with congenital heart disease and correlate it with surgical mortality. Serum was collected before surgery and at 24 postoperative h from 109 neonates and infants with congenital heart disease. All patients had presurgical transthoracic echocardiograms and CPB with or without hypothermic circulatory arrest. S100B concentrations were determined using a two-site immunoluminometric assay (Sangtec 100). Thirty-day surgical mortality was observed. All neonates had significantly increased S100B concentrations before surgery that decreased by 24 postoperative h. Preoperative S100B concentrations in 32 neonates with hypoplastic left heart syndrome correlated inversely with the forward flow and size of the ascending aorta and postoperative mortality (r(2) = -0.63; P = 0.03). Among infants, increased pulmonary blood flow was associated with higher S100B levels before surgery than cyanosis. There was no correlation with postoperative S100B and time on CPB, hypothermic circulatory arrest, or 30-day surgical mortality. In conclusion, preoperative S100B concentrations correlate inversely with the size of the ascending aorta in hypoplastic left heart syndrome and may serve as a marker for preexisting brain injury and mortality. IMPLICATIONS: Neonates with hypoplastic left heart syndrome and no forward flow in the ascending aorta may have brain injury at birth before heart surgery.     

早期联合测定各项生物标志物对评估脊髓损伤的临床意义

目的 探讨早期联合测定各项生物标志物对评价脊髓损伤的临床意义.方法 回顾性分析自2017-01-2018-12诊治的22例脊髓损伤,比较入院时和术后6个月Frankel等级,11例Frankel等级有1个或1个以上级别的改善,定义为B组;11例Frankel等级无改变,定义为C组,并纳入同期20例健康体检者为A组.比较...     

Cerebral and extracerebral release of protein S100B in cardiac surgical patients

Although several clinical studies have shown that increased serum concentrations of protein S100B predict ischaemic brain damage after cardiac surgery, S100B may also be released from the heart or other injured tissue. We therefore investigated the correlation between serum S100B levels and those of the specific cardiac marker troponin I in order to assess the cerebral vs. extracerebral origin of S100B. In 64 cardiac surgical patients, serial blood samples were drawn for the measurement of S100B and troponin I before surgery and for seven days after surgery. Neurological function was assessed before with the National Institutes of Health Stroke Scale and the Folstein Mini Mental Test. The data show that a sustained increase in serum S100B levels is associated with neurological dysfunction, as witnessed by a positive correlation between S100B values and the results of the neuropsychological tests. In contrast, the early postoperative increased levels of protein S100B derive from cardiac tissue, as shown by the positive correlation between S100B and cardiac troponin I levels.