杨纪辉　孔志

[关键词] 酒精依赖;S100B蛋白;戒断状态;震颤谵妄

[中图分类号] R743.33;R255.2          [文献标识码] A          [文章编号] 1673-9701（2021）23-0010-03

Expression level of serum S100B protein in patients with alcohol dependence under different abstinence conditions

YANG Jihui   KONG Zhi

Department of Addiction Medicine，Shenzhen Kangning Hospital，Shenzhen   518020，China

[Abstract] Objective To investigate the expression level of serum S100B protein in patients with alcohol dependence under different abstinence conditions. Methods A total of 81 male patients with alcohol-dependence admitted to the Department of Addiction Medicine in Shenzhen Kangning Hospital from January 2018 to May 2020 were selected. And they were divided into the group of delirium tremens in abstinence reaction period （n=27），the group of psychotic disorder in abstinence reaction period （n=27） and the group of simple abstinence reaction （n=27）. The concentration of serum S100B protein was detected by chemiluminescence immunoassay sandwich method，and the differences in the three groups were compared. Results There were no statistically significant differences in age，education level，course of alcohol addiction and daily average alcohol consumption in the three groups （P>0.05）. The expression levels of serum S100B protein were not the same in the three groups，with statistically significant difference （P<0.05）. The concentration of serum S100B protein of the delirium tremens group was （0.052 [0.032， 0.071）] ng/mL，which was higher than that of （0.035 [0.025， 0.044] ng/mL） in the simple abstinence reaction group，with statistically significant difference between the two groups （P<0.05）. However，there was no statistically significant difference in the concentration of serum S100B protein between the psychotic disorder group （0.049 [0.033， 0.062] ng/mL） and the delirium tremens group or the simple abstinence reaction group （P>0.05）. Conclusion The occurrence of delirium tremens in alcohol dependence patients in abstinence reaction period indicates more severe brain damage，and S100B protein may be a biological predictor of alcoholic delirium.

[Key words] Alcohol dependence; S100B protein; Abstinence condition; Delirium tremens

近年來，很多研究发现精神疾病与S100B蛋白关系密切，精神疾病患者的外周血清S100B蛋白浓度显著升高[1-3]，但关于酒精成瘾与S100B蛋白关系的研究罕见。现医学界形成比较统一的共识，S100B在生理水平对神经细胞起到重要的保护作用，如果浓度异常升高，可引起神经细胞的变性、凋亡[4]。有学者建议，S100B蛋白表达水平可作为反映大脑损伤的一个特异生物学指标[5]，血清S100B蛋白的浓度可能反映酒精性神经毒性损伤程度[6]。酒精依赖患者停酒后出现戒断反应，会有不同的临床类型表现，有的进展为震颤谵妄，有的伴发精神病性症状，有的仅出现单纯的戒断反应，医务人员主要依靠主观经验进行病情评估，缺乏相应的客观生物学指标衡量不同类型的戒断状态下患者的脑损伤程度。本研究拟探讨S100B蛋白在酒精依赖患者不同类型戒断状态下的表达水平，为临床评估酒精依赖戒断期的大脑损伤和病情严重程度提供客观参考指标，现报道如下。

1 资料与方法

1.1 一般资料

纳入2018年1月至2020年5月深圳市精神卫生中心成瘾医学科住院的81例酒精依赖患者。纳入标准：①符合《国际疾病分类（第 10 版）》（International Classification of Diseases，tenth edition，ICD-10）酒精依赖的诊断标准;②年龄18～55岁，男性;③入院时处于戒断期，临床研究所酒精依赖戒断评估表（Clinic Institute Alcohol Withdrawal Syndrome Scale，CIWA-Ar）得分7分及以上[7];④未合并其他精神疾病，如双相障碍、抑郁症、精神分裂症等及严重躯体疾病;⑤除烟草、酒精外无其他物质依赖史;⑥均获得患者知情同意。根……