Relationship Of S100B And ICP To Clinical Severity And Prognosis After Traumatic Brain Injury

Objective:Biomarkers may offer diagnostic and prognostic tools in addition to clinical indices after traumatic brain injury (TBI). The most recognizable neurocritical emergency is the acute elevation of intracranial pressure (ICP) and S100B is a protein biomarker that reflects CNS injury. It can be measured in the CSF or serum. This study aims to investigate the relationship of S100B and ICP to clinical severity and prognosis after TBI. Analysis of the relation between S100B and ICP was undertaken. Methods:Forty-five patients at the Xiang Ya Hospital enrolled from Mar. to Oct. in2011were classified into3cohorts according to Glasgow score (GCS score):minor grade, moderate and severe(case group),25cases of them were treated with an ICP monitoring(ICP monitoring group). ICP monitoring group was divided into4groups:normal (<15mmHg), light (15～20mmHg), moderate (21～40mmHg) and heavy (>40mmHg). S100B levels were analyzed in CSF and serum collected1day,3day,5day,7day after TBI by ELISA. ICP datum and GCS scores were recorded in ICP monitoring group meantime. Respectively6operative patients with hernia or varicose vein whose S100B levels in CSF and serum were used as control group. Outcome was assessed using the Glasgow Outcome Scale(GOS score). GOS scores dichotomised as unfavourable (GOS1-3) and favourable (GOS4-5)were collected6months after TBI. SPSS17.0was applied to investigate the relationship of S100B and ICP to clinical severity and prognosis after TBI. Analysis of the relation between S100B and ICP was undertaken. Results:1. Differences of S100B levels in serum and CSF among different case groups being significant. GCS scores were negatively correlated with S100B levels in serum and CSF. Positive correlation was found between S100B levels in serum and in CSF in case groups. We proved significantly higher values of S100B in serum and CSF in unfavourable outcome group. S100B levels were negatively associated with GOS scores.2. ICP had a negative correlation GCS scores and GOS scores.3. The differences of S100B level among different initial ICP were statistical significance. There is a positive correlation between S100B levels in serum and CSF with ICP. Conclusion:1. S100B protein, as a neuronal specific biomarker, can be measured in serum and CSF used as a significant biochemical marker for severity and prognosis after TBI;2. ICP monitoring is a important physiological index related closely with severity and prognosis after TBI;3. In conjunction with clinical manifestation and radiologic evidence, uniting monitoring S100B and ICP may serve to enhance prediction of early clinical trends following TBI.