蛛网膜下腔出血后脑脊液和血清中S—100B蛋白含量变化的实验研究

目的研究蛛网膜下腔出血（SAH）后脑脊液和血清中S-100B蛋白含量的动态变化及意义。方法将15只雄性新西兰白兔采用完全随机分组方法平均分为3组：①对照组；②小量注血组（0．4ml／kg）；③大量注血组（1．0ml／kg）。采用枕大池一次注血法建立兔SAH模型。分别收集注血后1、2、3、5、7天脑脊液和血清标本，用酶联免疫吸附（ELISA）法检测其中S-100B的含量。另将15只雄性新西兰白兔按上述方法分组，于注血后2d采用灌注固定法处死动物，采用原位细胞凋亡检测法（TUNEL）检测颞叶皮层细胞凋亡情况。结果对照组脑脊液和血清中S-100B蛋白无明显变化。小量注血组注血后第1天脑脊液中S-100B蛋白含量增高，第3天后下降至正常，而血清中无明显变化。大量注血组脑脊液和血清中S-100B蛋白明显升高，但两者变化不平行。大剂量注血组颞叶皮层细胞凋亡率高于小剂量注血组（P〈0．05），两者均高于对照组（P〈0．05）。结论在SAH后早期动态检测脑脊液和血清中S-100B蛋白含量变化能反映脑损伤的程度。

Dynamical Assay Of S-100B Proteins in Serum and Cerebrospinal Fluid after Subarachnoid Hemorrhage in Rabbits

Objective To study the dynamical changes in S-100B proteins in the serum and cerebrospinal fluid （CSF） after the experimental subarachnoid hemorrhage（SAH） and its clinical significance in rabbits. Methods Fifteen male rabbits were equally and randomly divided into three groups, i.e. control group, mild SAH （0.4 ml/kg of autologous blood was injected into the cistern magna of rabbits） and severe SAH （1.0 ml/kg of autologous blood was injected in the cistern magna） group. The levels of S-100B protein in serum and CSF were measured by enzyme-linked immunosorbent assay （ELISA） before the SAH and 1, 2, 3, 5 and 7 days after the SAH. Another 15 male rabbits also were equally and randomly divided into the three groups as the above-mentioned ones. The apoptosis of neurons in the inferior temporal lobes of the rabbits in the later three groups was determined by TdT-mediated nick end labeling （TUNEL） 2 days after SAH. Results The CSF S-100B protein l, 2 and 3 days after SAH were significantly higher in the mild SAH group than that in the control group （P〈0.01）. The CSF levels of S-100B protein were significantly higher in the sever SAH group 1, 2 and 3 days after the SAH than those in both the control and mild SAH groups （P〈0.01）. The CSF levels of S-100B protein 5 days after SAH was still significantly higher in the sever SAH group than that in the control groups （P〈0.01）. There were insignificant difference in the serum levels among these three group （P〉0.05）. The apoptosis rate of the neurons in the severe SAH group were significantly higher than that in the mild SAH group （P〈0.05）, where the apoptosis rates of the neurons was significantly higher than that in the control group. Conclusion The CSF levels of S-100B protein early after the SAH may serve as an indicator of the severity of SAH.