杨珉　王威　魏俊　吴学群　董伟　饶辉

【摘要】 目的：分析研討重型颅脑损伤患者血清S-100β、C-反应蛋白（CRP）动态水平变化及其临床意义。方法：此次讨论中所研讨的96例患者均随机从2014年5月-2016年5月本院收治的重型颅脑损伤患者中筛选而出，入院时根据GCS（格拉斯哥昏迷评分）将98例患者分为重型组和特重型组，另选取43例正常体检者设为对照组。应用ELISA（酶联免疫吸附法）检测血清中S-100β浓度，应用蛋白分析仪来检测CRP的浓度。结果：特重型组和重型组颅脑外伤患者血清S-100β及CRP的含量均明显高于对照组，差异均有统计学意义（P<0.05）；特重型组患者血清S-100β含量明显高于重型组，差异有统计学意义（P<0.05）；特重型组患者血清CRP含量与重型组比较，差异无统计学意义（P>0.05）；三种不同类型颅脑损伤的血清S-100β含量比较，差异均有统计学意义（P<0.05）；三种不同类型颅脑损伤的血清CRP含量比较，差异均无统计学意义（P>0.05）；患者入院后第2天血清S-100β及CRP的含量值达到峰值，血清S-100β在7 d内下降迅速，逐渐接近正常；血清CRP在7 d内下降缓慢。结论：重型颅脑损伤患者入院初期血清S-100β及CRP水平增高与疾病的出现密切相关。CRP检测值不能够完全区分脑损伤类型及程度。血清S-100β可作为判定脑损伤的指标，血清S-100β含量越高表明脑损伤程度越严重，并且能够将脑损伤类型区分出，可以为治疗及预后评估提供理论依据，具有临床推广及应用价值。

【关键词】 C-反应蛋白； 血清S-100β； 重型颅脑损伤； 临床意义

Research on Dynamic Level Change and Its Clinical Significance of Serum Levels of S-100β and C- reactive Protein in Patients with Severe Brain Injury/YANG Min，WANG Wei，WEI Jun，et al.//Medical Innovation of China，2017，14（05）：077-081

【Abstract】 Objective：To analyze and probe into the dynamic level change and its clinical significance of serum levels of S-100β and C-reactive protein（CRP） in patients with severe brain injury.Method：A total of 96 cases of patients with severe craniocerebral injury and who accepted treatments in our hospital from May 2014 to May 2016 were selected in this discussion，and according to Glasgow coma score（GCS），98 patients were divided into severe group and extra severe group，and 43 normal subjects were selected as the control group.Then，serum S-100β concentration was detected by enzyme linked immunosorbent assay（ELISA），and CRP concentration was detected by protein analyzer.Result：The content of serum S-100β and C-reactive protein of patients in severe and extra severe brain injury were significantly higher than that of the control group，and the data among three groups was statistically significant（P<0.05）.The content of serum S-100β in extra severe group was significantly higher than that of severe group，and the data were statistically significant（P<0.05）.There was no significant difference in serum levels of CRP between the groups and there was no significant difference between the extra severe patients and the severe patients，and the data was not statistically significant（P>0.05）.The content of serum S-100β was significantly different between three different types of brain injury，and the data were statistically significant（P<0.05）.There was no significant difference in serum CRP levels between three different types of brain injury，and there was no significant difference between the groups（P>0.05）.The content of serum S-100β and CRP were reached the peak at second days after admission.And serum S-100β was rapidly decreased in 7 days，and was gradually approached to normal.Serum CRP was slowly decreased in 7 days.Conclusion：The increase of level of serum S-100β and CRP in patients with severe brain injury in the early stage of admission are closely related to the emergence of disease.CRP detection values can not completely distinguish the types and extent of brain injury.And serum S-100 β can be used to predict the brain injury index，the higher the content of S-100β in serum showes the more serious brain injury，but also can distinguish the type of brain injury，can provide a theoretical basis for treatment and prognosis assessment，thus it has clinical promotion and application value.

【Key words】 C-reactive protein； Serum S-100β； Severe brain injury； Clinical significance

First-authors address：The Affiliated Xiaogan Hospital of Wuhan University of Science and Technology，Xiaogan 432000，China

doi：10.3969/j.issn.1674-4985.2017.05.019

我国每年大约有数十万人是死于创伤，至少有50%是死于颅脑创伤。并且颅脑创伤的致残率和病死率都极高[1]，这给患者的家庭和社会带来了巨大的负担。为此，颅脑创伤是非常严重的卫生问题，需要不断地提高治疗水平。近几年来随着我国对血清生化标志物不断深入的研究，大量反馈神经损伤的相关指标逐渐应用到颅脑外伤的研究中[2]。……