Phentolamine administration increases blood S100B protein levels in pediatric open-heart surgery patients

AIM: Phentolamine administration during open-heart surgery shortens the cooling and rewarming phases of cardiopulmonary bypass (CPB) and hastens weaning from mechanical ventilation and extubation. Data on the effects of phentolamine on cerebral circulation and function in this setting are lacking. This study reports the cerebral effects of phentolamine using blood S100B protein levels and the middle cerebral artery pulsatility index (MCA PI). METHODS: Sixty pediatric patients undergoing congenital heart disease repair were randomly assigned to receive either phentolamine 0.2 mg kg(-1) i.v. (n = 30) or placebo (n = 30) before the cooling and rewarming phases of CPB. Samples for S100B measurement were collected at seven predetermined time-points before, during and after surgery. MCA PI values were recorded at the same times as sampling. RESULTS: S100B blood levels were higher in the phentolamine-treated group than in controls after rewarming (3.53 +/- 1.88 vs 1.58 +/- 0.53 microg l(-1); p < 0.001), remained persistently higher at the end of surgery (2.95 +/- 0.91 vs 0.79 +/- 0.21 microg l(-1); p < 0.001) and returned to normal ranges 12 h later than in the placebo group (p > 0.05). MCA PI values were also significantly higher at the end of surgery in the phentolamine-treated group (1.83 +/- 0.50 vs 1.22 +/- 0.34; p < 0.01). Cooling and rewarming times were shorter in the phentolamine-treated group (p < 0.01, for all). CONCLUSION: Despite improved peripheral vasodilatation and perfusion, phentolamine administration in pediatric open-heart surgery is correlated with increased cerebrovascular resistance and brain damage.     

早产儿血清S100B蛋白与脑损伤的关系

目的：探讨血清S100B蛋白在早产儿脑损伤中的变化及意义。方法：47名早产儿纳入本研究,根据影像学MRI和头颅B超检查结果分为无脑损伤组（20 例）、非脑白质损伤组（14例）和脑白质损伤组（13例）。留取生后＜24 h、72 h及7 d的血清样本,采用酶联免疫吸附测定法（ELISA）双抗体夹心法测定S100B蛋白水平。结果：脑白质损伤组和非脑白质损伤组出生后24 h、72 h及7 d血清S100B蛋白水平均明显高于无脑损伤组（P＜0.05）,且脑白质损伤组血清S100B蛋白水平在各监测时间点明显高于非脑白质损伤组（P＜0.05）。结论：脑损伤早产儿生后7 d内血清S100B蛋白水平增高,提示血清S100B蛋白可以作为一种脑损伤的早期敏感标志物,对于临床早产儿脑损伤特别是脑白质损伤的诊断更有意义。     

血清S100B蛋白在新生儿窒息后脑损伤中的临床意义

目的：S100B蛋白是一种脑特异性蛋白,可反映脑损伤的程度。该研究旨在探讨窒息新生儿脐血及生后血清S100B蛋白的变化及对新生儿窒息诊断和窒息后脑损伤判断的价值。方法：对窒息新生儿的脐血及生后1,3,7d血清S100B蛋白变化进行分析。结果：①窒息新生儿脐血S100B蛋白水平高于正常对照组,差异有显著性(P<0.05),轻度窒息与重度窒息患儿脐血S100B蛋白含量差异无显著性;②出生后1～7d内轻度窒息患儿血清S100B蛋白无明显变化,重度窒息脑损伤患儿血清S100B蛋白呈逐渐增高趋势,生后第7天时重度窒息脑损伤患儿血清S100B蛋白明显高于轻度窒息患儿(P<0.01);③死亡的窒息患儿生后第7天的血清S100B蛋白含量高于存活儿,但差异无显著性(P>0.05);④发生颅内出血和/或脑水肿的患儿生后第3天血清S100B蛋白含量增高,差异有显著性(P<0.05)。结论：血清S100B蛋白检测有助于新生儿窒息的诊断及窒息后脑损伤的判断。     

尿S-100B蛋白动态变化对早产儿脑损伤的诊断价值

目的探讨尿S-100B蛋白水平动态变化在早期诊断早产儿脑损伤中的价值。方法选择2012年1月至12月住院的胎龄35周的早产儿76例,分别留取生后24、72、120 h尿液,应用化学发光法检测S-100B蛋白含量。根据颅脑超声及磁共振成像(MRI)检查结果,将其分为脑室周围白质软化(PVL)组(16例)、脑室周围及脑室内出血(PVH-IVH)组(20例)及无脑损伤组(40例),比较各组间S-100B的变化。结果在生后24、72、120 h各时间点,无脑损伤组、PVL组和PVH-IVH组三组间尿S100B蛋白水平差异有统计学意义(P均0.01);在各时间点,均以无脑损伤组最低,PVL组最高,差异有统计学意义(P均0.01)。PVL组和PVH-IVH组尿S100B蛋白水平随时间点推移的差异有统计学意义(P均0.01);均在72 h达到高峰,120 h时有所下降。结论尿S100-B蛋白水平可作为早期预测脑损伤的敏感标志物,动态监测有助于判断疾病严重程度及评估患儿预后。     

脑白质损伤早产儿血清髓鞘碱性蛋白和S1OOB蛋白的变化及与预后的关系

目的 探讨脑白质损伤( periventricular leukomalacia,PVL)患儿血清髓鞘碱性蛋白(myelin basic protein,MBP)及S100B蛋门(S100B protein,S100B)的动态变化及其与患儿预后的关系.方法 对2007年11月至2008年7月我院住院的78例PVL早产儿(PVL组)和43例正常早产儿(正常对照组),分别在其生后第1、3、7、14天测定血清中MBP及S100B含量.30例正常早产儿及69例PVL患儿出院后每3个月随方1次,直至纠正胎龄至1岁,用Gesell发育量表测定其智力以及运动发育情况.结果 (1) PVL组患儿血清MBP于生后第1天升高[(7.61±1.78) μg/L]、第3天达峰值[( 14.53±3.12) μg/L],后随病情好转,逐渐降低;与正常对照组比较,PVL组患儿在生后第1、3、7、14天血清MBP水平均明显高于正常对照组(P＜0.05).(2) PVL组患儿血清S100B水平在生后第1、3、7天明显升高[(3.82±0.68),(4.41±0.91),(5.78±1.54) μg/L],第7天达峰值,与正常对照组比较,差异有统计学意义(P＜0.05);至生后第14天时,S100B明显降低,两组比较已无明显差异(P＞0.05).(3) PVL组患儿生后第7天血清S100B、MBP持续升高者,随访至1岁时其发育商比生后第7天血清S100B及MBP明显下降者落后;也明显落后于正常早产儿(P＜0.05).结论 PVL患儿生后血清MBP及S100B水平与病情严重程度相关.如患儿血清MBP及S100B持续升高超过7d,则发育商明显落后,预后不良.     

Kinetics of serum S100B in newborns with intracranial lesions.

BACKGROUND: The purpose of the present study was to evaluate the usefulness of serum S100B as a clinical marker of intracranial lesions in newborns. METHODS: The study involved 22 normal and 40 diseased newborns. Serum S100B level was measured on days 1 and 6 in normal newborns. Diseased newborns were classified into four groups: birth asphyxia with hypoxic-ischemic encephalopathy (HIE); birth asphyxia without HIE; intracranial hemorrhage (mainly subarachnoid); and brain malformation. In each group the serum S100B level was measured on days 1, 2 and 6. Development was also assessed to investigate the relation between serum S100B level and prognosis at 18 months after birth. RESULTS: In normal newborns, serum S100B level was significantly higher in those with liquor to meconium stain than in those without. In diseased newborns, serum S100B level on day 1 was significantly higher in the HIE group than in all other groups (P < 0.05). There was no significant difference in serum S100B level between control and intracranial hemorrhage, or brain malformation. In newborns with birth asphyxia, serum S100B level was significantly higher in severe birth asphyxia than in mild or moderate birth asphyxia; two newborns with serum S100B level > or =10 microg/L on days 1 and 2 developed cerebral palsy, others with no increase of S100B were all developing normally. CONCLUSIONS: Serum S100B level is a useful marker of acute perinatal brain damage, and is particularly valuable for fetal distress. In newborns with birth asphyxia, serum S100B levels serve as a biochemical marker of HIE.     

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??Abstract?? Objective To discuss the changes of S100B protein and GFAP levels and its relationship with 1 min Apgar scoring in the serum of neonates born to mothers with preeclampsia of different degrees. Methods From Oct.2012 to Mar.2013 in Chilren’s hospital of Shanxi province ?? 40 cases of newborns born to mothers with preeclampsia were divided into two groups: mild preeclampsia group ??L group 20 cases????severe preeclampsia group ??H group 20 cases????a healthy control group was established ??N group 20 cases????newborns of three groups were taken specimen at the time of admission ?? dual- antibody sandwich enzyme-linked immunosorbent assay ??ELISA?? was used to detect the level of serum GFAP and S100B . In the first three days after admission cranial ultrasound was performed in each child. Results The difference among the L??H and N group was statistically significant ??P2=17.20??P??0.05??; S100B and GFAP levels in L and H group were positively correlated ??γ= 0.658?? P??0.05??; S100B?? GFAP levels in L and H group and neonatal 1min Apgar score were negatively correlated ??γ$subScript$S100B$/subScript$=-0.482??γ$subScript$GFAP$/subScript$=-0.534??P??0.01??. Conclusion The more serious eclampsia?? the greater the possibility of brain damage?? and the more serious the elevation of S100B and GFAP levels?? and was negatively correlated with 1 min Apgar score?? which indicates that the possibility of S100B protein and GFAP as a predictor of neonatal brain injury deserves further study.     

S100B蛋白、胶质纤维酸性蛋白和神经元特异性烯醇化酶在早产儿脑损伤中的意义

早产儿脑损伤是造成早产儿伤残的重要原因,影像学检查有时间滞后性.寻找一种简单、及时、准确地预测早产儿脑损伤的生物学标志物尤为重要.本文对早产儿脑损伤的生物标志物S100B蛋白、胶质纤维酸性蛋白和神经元特异性烯醇化酶在早产儿脑损伤中的作用作一综述,探讨其对早产儿脑损伤早期诊断的意义.     

S-100B蛋白动态变化对窒息新生儿脑损伤诊断价值的研究

目的 探讨S-100B蛋白水平动态变化对早期诊断新生儿缺氧缺血性脑病(HIE)的价值.方法 选择2009年5月至2011年5月我院新生儿重症监护病房收治的窒息新生儿为病例组,同期随机选取我院出生的40例健康新生儿为对照组,分别于生后6h内、(72±6)h取血检测血清S-100B蛋白水平,并与7天内最终确诊HIE的程度进行对照分析.结果 轻度窒息组和重度窒息组生后6h内血清S-100B蛋白水平均高于对照组[(0.40 ±0.24) μg/L、(0.89±0.34) μg/L比(0.28 ±0.14) μg/L],重度窒息组高于轻度窒息组,P均＜0.01.生后72 h,轻度窒息组已恢复至对照组水平(P＞0.05),重度窒息组仍高于轻度窒息组[(0.44±0.21) μg/L比(0.26±0.10) μg/L,P＜0.01].窒息合并颅内出血患儿生后6h内、72 h血清S-100B蛋白水平均高于重度窒息组[(2.61±1.08) μg/L比(0.89±0.34) μg/L,(1.64±0.71) μg/L比(0.44±0.21) μg/L,P＜0.01].生后6h内血清S-100B蛋白水平诊断HIE的敏感度及阴性预测值分别为97.4％、97.7％,但特异度及阳性预测值较低.生后72 h血清S-100B蛋白水平诊断HIE的特异度及阳性预测值均为100％,但敏感度及阴性预测值较低.故以6h内血清S-100B蛋白水平作为HIE初筛指标可以减少漏诊,结合72 h血清S-100B蛋白水平可以提高中重度HIE的诊断特异度.结论 动态监测新生儿窒息后72 h内血清S-100B蛋白水平可作为早期评价脑损伤的敏感指标,为HIE的早期诊断及干预治疗提供客观依据.     

血清S100B蛋白和脑脊液胆红素水平在新生儿高未结合胆红素血症中检测的意义

目的探讨高未结合胆红素血症新生儿血清S100B蛋白和脑脊液(CSF)胆红素水平检测的意义。方法 2008年6月-2010年6月在本院住院的高未结合胆红素血症新生儿86例,根据有无高危因素(溶血、感染、低蛋白、小日龄)分为有高危因素组(42例)和无高危因素组(44例),并选取同期住院无黄疸新生儿作为对照组(30例)。每组患儿在入院时即用ELISA法检测其血清S100B蛋白水平,并检测其CSF及血清胆红素水平,同时对每例患儿进行听力筛查和新生儿行为能力测定(NBNA),对上述结果在3组间进行比较。结果高危因素组血清胆红素水平与CSF胆红素水平呈正相关(P<0.01);无高危因素组血清胆红素水平与CSF胆红素水平无相关性(P>0.05)。高危因素组CSF胆红素水平和血清S100B水平与NBNA评分均呈负相关(Pa<0.05);无高危因素组CSF胆红素水平和血清S100B水平与NBNA评分均无相关性(Pa>0.05)。3组NBNA评分、血清胆红素水平、CSF胆红素水平及血清S100B水平比较,差异均有统计学意义(Pa<0.05)。3组患儿听力筛查异常率比较有统计学差异(P<0.01),组间比较Scheffé可信区间法提示无高危因素组患儿听力筛查异常率显著低于高危因素组(0.133～0.249)。结论高危因素组血清S100B蛋白和CSF胆红素水平明显升高,提示新生儿期高未结合胆红素血症对有高危因素患儿的神经系统可造成损伤。     

尿S100B蛋白和乳酸/肌酐在新生儿缺氧缺血性脑病早期诊断中的应用价值

目的探讨尿S100B蛋白、尿乳酸／肌酐比值对新生儿缺氧缺血性脑病（HIE）早期诊断的应用价值。方法检测58例足月HIE患儿在生后第1天、第2天、第3天,尿S100B蛋白、尿乳酸／肌酐比值水平．并在生后7天内进行HIE临床分度,以同期25例足月正常新生儿对照组。结果HIE组出生后3天内尿S100B蛋白含量和出生后1天内尿乳酸／肌酐比值明显高于对照组（P〈0．001）;3天内尿S100B蛋白和1天内尿乳酸／肌酐比值之间及与HIE的临床分度呈正相关（P〈0．001）;当尿S100B蛋白水平在0．47μg／L,尿乳酸／肌酐比值在0．55时,单独检测第3天尿S100B蛋白敏感度、特异度分别为90．4％、91．9％;尿乳酸／肌酐比值预测HIE的敏感度和特异度以出生后第1天最高,分别为91．5％和90．3％;如检测第3天尿S100B蛋白的同时监测生后1天内尿乳酸／肌酐比值可显著提高HIE诊断的准确性,联合应用两项指标进行检测,诊断的敏感度和特异度分别为98.8％、97．4％,较两种方法单独应用敏感度和特异度均提高。结论对窒息患儿以临床表现为基础,同时监测出生后3天内尿S100B蛋白和尿乳酸／肌酐比值,对提高HIE的早期诊断和临床分度具有一定的应用价值。     

血清S100B蛋白和神经元特异性烯醇化酶预测手足口病严重程度的价值

目的探讨手足口病(HFMD)患儿血清S100B蛋白和神经元特异性烯醇化酶(NSE)水平检测对预测HFMD严重程度的价值。方法将90例HFMD患儿分为普通型、重型和危重型3组,每组30例;随机选取30例健康儿童作为对照组。ELISA法检测治疗前及治疗后7 d血清S100B蛋白和NSE水平。采用受试者操作特征曲线(ROC曲线)评价S100B蛋白和NSE对HFMD严重程度的预测效能。结果危重型HFMD患儿血清S100B蛋白和NSE水平均较其他3组明显升高(P0.01);重型患儿血清S100B蛋白和NSE水平均较普通型和对照组明显升高(P0.01)。与治疗前比较,危重型组和重型组治疗后血清S100B蛋白及NSE水平明显下降(P0.05)。当血清S100B蛋白在0.445μg/L时其Youden值最大,为0.611,其对重症HFMD(包括重型和危重型HFMD)预测的灵敏度为61%,特异度为100%。血清NSE在5.905μg/L时其Youden值最大,为0.533,其对重症HFMD预测的灵敏度为80%,特异度为73%。两个指标并联检测的灵敏度为86%,特异度为73%,对预测重症HFMD的价值最高。结论血清S100B蛋白和NSE有助于判断HFMD病情严重程度及治疗效果;二者如能并联检测对重症HFMD的预测价值更高。     

血清S-100B蛋白在新生儿缺氧缺血性脑病诊断中的价值

目的探讨血清S-100B蛋白水平在缺氧缺血性脑病(HIE)新生儿早期诊断、病情进展中的价值。方法HIE组新生儿46例(轻度31例,中重度15例),健康对照组43例为健康足月新生儿。采用酶联免疫吸附法(ELISA)检测二组脐血和生后24h血清S-100B蛋白水平。结果1.健康对照组性别、出生体质量对脐血、24h血清S-100B蛋白水平无影响;2.健康对照与HIE组脐血血清S-100B蛋白水平分别为(1.03±0.32)和(2.53±1.1)μg/L,二组比较有显著性差异(t′=8.848P<0.05);轻度HIE组与中重度HIE组脐血血清S-100B蛋白水平分别为(2.06±0.65)和(3.49±1.23)μg/L,与健康对照组比较均有显著性差异(F=79.691P<0.01);3.健康对照与HIE组24h血清S-100B蛋白水平分别为(1.07±0.32)与(3.83±2.32)μg/L,二组比较有显著差异(t′=7.631P<0.05);4.轻度与中重度HIE组24h血清S-100B蛋白水平分别为(2.84±1.06)和(6.11±2.83)μg/L,与健康对照组比较均有显著差异(F=48.224P<0.01);5.HIE组脐血与24h血清S-100B蛋白水平呈显著正相关(r=0.6177P<0.001)。结论1.健康足月新生儿出生体质量及性别对血清S-100B蛋白水平无影响。2.脐血和24h血清S-100B蛋白水平均提示HIE的发生,且能反映其严重程度;脐血S-100B对早期预测HIE的发生更有意义。     

Serum and cerebrospinal fluid S100B,neuron‐specific enolase,and total tau protein in acute encephalopathy with biphasic seizures and late reduced diffusion: A diagnostic validity

Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is characterized clinically by biphasic seizures and late magnetic resonance imaging abnormalities, such as reduced subcortical diffusion from day 3 onwards, often accompanied with some neurological sequelae. In the early stages of the disease, AESD closely resembles its far more prevalent and relatively benign counterpart, febrile seizure (FS). Methods: We measured and compared the serum or cerebrospinal fluid (CSF) levels of S100B, neuron‐specific enolase (NSE), and total tau protein in 43 patients with FS and 18 patients with AESD, at any point during the disease. To assess early diagnostic validity, we compared these biomarkers in 43 FS and eight AESD patients, with whom the day 0–2 samples were available. We used the receiver–operator characteristic curve to evaluate the diagnostic values of these markers. Results: The levels of all biomarkers were significantly higher in AESD than FS patients. When only day 0–2 samples from AESD patients were used, the levels of all the measured biomarkers, except serum NSE, were still significantly higher in patients with AESD than in FS, suggesting that AESD could damage astrocytes, neurons, and axons, even in the early stages of the disease. According to the receiver–operator characteristic curve analyses, CSF S100B (cut‐off value, 100 pg/mL) and CSF total tau protein (cut‐off value, 100 pg/mL) were better predictors of AESD than other biomarkers. Conclusion: The combination of CSF S100B and CSF total tau protein resulted in a positive predictive value of AESD 83.3%, which could be helpful for early diagnosis, facilitating early therapeutic interventions.