S100β、IL-6、hs-CRP联合检测明显提高急性创伤性颅脑损伤诊断的灵敏性

doi:10.3969/j.issn.1006-5725.2024.11.019

Abstract

Abstract:

Objective Through the combined detection method， we tried to find more sensitive biomarkers for the diagnosis of acute TBI， which might provide the exact diagnosis， treatment and monitoring indicators for the clinic. Methods A total of 156 patients with acute TBI admitted to the Emergency Traumatic Center of Yan'an Hospital of Kunming from October 2022 to June 2023 were collected and included the normal and fracture control groups. Peripheral blood samples of the enrolled patients were collected and monitored， S100β and IL-6 were tested and clinical data such as hs-CRP was collected immediately upon admission， then statistical analysisanalysis was conducted. Results Peripheral blood in patients with acute TBI， The levels of S100β， IL-6 and hs-CRP significantly increased， and the area under the ROC curve for diagnosing acute TBI was 0.944， 0.915， and 0.897. The combined detection of the three indicators showed an area under the ROC curve of up to 0.975. Person correlation analysis found a positive correlation between the three indicators， especially S100β with IL-6， The correlation coefficient between them is 0.715. Binary logistic regression analysis found that S100β， IL-6 and hs-CRP are independent risk factors for acute TBI. Conclusions The combined detection of S100β， IL-6 and hs-CRP can effectively improve the sensitivity of acute TBI diagnosis. The mutual promotion of S100β and IL-6 may aggravate the secondary craniocerebral injury caused by inflammatory mechanism， and early targeted treatment may improve the prognosis.

Key words: traumatic brain injury, inflammation, S100β, interleukin-6

CLC Number:

R641

Xiaogai NIE,Chuanmei PENG,Yunfang ZHANG,Kun TU,Jiao. WANG. The combined detection of S100β， IL-6 and hs CRP significantly improves the sensitivity of acute TBI diagnosis[J]. The Journal of Practical Medicine, 2024, 40(11): 1580-1585.

Figures/Tables 7

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References 24

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分组/性别、年龄		急性TBI组（n = 156）	正常对照组（n = 60）	骨折对照组（n = 37）	χ²/F值	P值
性别（例）	男	113	45	25	0.281	0.755
性别（例）	女	43	15	12	0.281	0.755
年龄（x ± s，岁）		51.97 ± 20.31	49.92 ± 8.3	51.27 ± 19.29	0.774	0.51

外周血指标	监测时间			F值	P值
外周血指标	入院即刻	入院24 h	入院48 h	F值	P值
S100β	1 587.83 ± 223.65	1 620.30 ± 255.90	1 489.30 ± 253.50	3.728	0.026
IL-6	62.66 ± 9.19	62.02 ± 9.60	63.32 ± 10.41	0.213	0.808

分组	S100β （pg/mL）	IL-6 （pg/mL）	WBC （× 10⁹/L）	hs-CRP（mg/L）	AST (U/L)	SJ-GLU （mmol/L）	DD二聚体（mg/L）
急性TBI组	1 552.43 ± 250.37^b	61.84 ± 9.45^b	13.71 ± 6.10^a	18.46 ± 33.43^ab	91.96 ± 90.36^a	8.33 ± 3.53^a	16.33 ± 15.16^a
正常对照组	782.85 ± 122.65	27.03 ± 4.96	6.04 ± 1.53	1.02 ± 1.22	30.58 ± 11.21	4.77 ± 0.54	0.25 ± 0.19
骨折对照组	1 236.25 ± 250.37^c	52.09 ± 8.65^c	13.98 ± 6.77^c	4.29 ± 7.59^c	91.35 ± 115.40^c	8.06 ± 3.06^c	16.00 ± 12.41^c
F值	291.792	364.715	45.198	11.347	12.251	30.924	35.717
P值	0.000	0.000	0.000	0.000	0.000	0.000	0.000

检验变量	AUC	SE	P值	95% CI
检验变量	AUC	SE	P值	下限	上限
S100β	0.944	0.013	0.000	0.918	0.970
IL6	0.915	0.020	0.000	0.876	0.954
hs?CRP	0.897	0.023	0.000	0.853	0.941
联合检测	0.975	0.008	0.000	0.959	0.992

		S100β	IL?6	CRPH
S100β	r	1	0.715^**	0.178^**
S100β	P值		0.000	0.004
IL6	r	0.715^**	1	0.188^**
IL6	P值	0.000		0.003
hs-CRP	r	0.178^**	0.188^**	1
hs-CRP	P值	0.004	0.003

The combined detection of S100β， IL-6 and hs CRP significantly improves the sensitivity of acute TBI diagnosis

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相关因素	回归系数	标准误差	Wald值	OR	95% CI		P值
相关因素	回归系数	标准误差	Wald值	OR	下限	上限	P值
S100β	0.009	0.002	20.624	1.009	1.005	1.014	0.000
IL6	0.109	0.030	13.446	1.116	1.052	1.183	0.000
WBC	0.017	0.044	0.155	1.018	0.933	1.110	0.694
hs-CRP	0.090	0.037	5.865	1.094	1.017	1.176	0.015
AST	0.003	0.003	1.236	1.003	0.997	1.009	0.266
GLU	0.036	0.111	0.107	1.037	0.835	1.288	0.743
DD	-0.010	0.021	0.237	0.990	0.950	1.031	0.626
常量	-18.929	3.605	27.569	0.000			0.000

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