Relationship between serum S100β and cerebrospinal fluid P38 protein and cognitive function after craniocerebral trauma
WANG Xiao MENG Lingwen▲
Department of Neurosurgery, Changzhou Medical District of the 904th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Jiangsu Province, Changzhou 213000, China
Abstract:Objective To investigate the relationship between serum soluble protein-100β (S100β) and cerebrospinal fluid P38 mitogen-activated protein kinase (P38) protein and cognitive function after craniocerebral trauma. Methods Seventy-five cases with craniocerebral trauma from February 2016 to February 2021 in the 904th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army were selected, who were treated surgically, and serum S100β and cerebrospinal fluid P38 protein levels were measured and divided into postoperative cognitive dysfunction (POCD) group (≤26 points) and non-POCD group (>26 points) according to the 15 d postoperative simple intelligence mini-mental state examination (MMSE) score. The general data and S100β and P38 protein levels of the two groups were compared, and logistic regression was used to analyze the influencing factors of POCD, while ROC was used to assess the predictive value of S100β and P38 protein in POCD. Results There were 21 patients with POCD and 54 patients without POCD in 75 cases 15 d after craniocerebral trauma, and the incidence of POCD was 28.00%. The GCS score of the POCD group was lower than that of the non-POCD group, while the percentage of temporal lobe injury and combined hypertension were higher than those of the non-POCD group, with statistically significant differences (P<0.05). The S100β level in the POCD group was higher than that in the non-POCD group, while the P38 protein level was lower than that in the non-POCD group, with statistically significant differences (P<0.05). Logistic regression analysis showed that GCS score, injury site, combined hypertension, S100β, and P38 protein were all risk factors for POCD (OR>1, P<0.05). ROC analysis showed that S100β and P38 proteins predicted POCD with cut-off values of 1.094 μg/L and 0.323, AUC values of 0.852 and 0.839, and AUC values of 0.942 for the combined assay. Conclusion After craniocerebral trauma the changes of S100 β and p38 protein in cerebrospinal fluid are closely related to cognitive function. It is not only the influencing factor of POCD, but also the reference factor to predict its occurrence.
汪潇 孟令文▲. 颅脑外伤术后血清S100β及脑脊液P38蛋白与认知功能的关系[J]. 中国医药导报, 2023, 20(7): 97-100,109.
WANG Xiao MENG Lingwen▲. Relationship between serum S100β and cerebrospinal fluid P38 protein and cognitive function after craniocerebral trauma. 中国医药导报, 2023, 20(7): 97-100,109.
[1] 周灵静,林莎莎,蒲秋江,等.2016―2019年达州市颅脑外伤存活司机创伤后成长状况及相关因素分析[J].安徽医药,2021,25(8):1572-1576.
[2] Kochoyan AL,Shahinian GG,Martemyanova AA,et al. The ability to recover cerebral function after an isolated craniocerebral trauma [J]. Sud Med Ekspert,2019,62(5):58-63.
[3] 金东,梁建广,吴春富,等.去骨瓣减压与还纳骨瓣在重型颅脑外伤手术中的应用比较[J].实用临床医药杂志,2021,25(20):81-84.
[4] Lin X,Chen Y,Zhang P,et al. The potential mechanism of postoperative cognitive dysfunction in older people [J]. Exp Gerontol,2020,12(130):110791.
[5] 孙鹏,李恒周,范多娇,等.血清5-羟色胺与中枢神经特异蛋白在评估创伤性脑损伤后认知障碍严重程度应用价值[J].临床军医杂志,2020,48(3):311-312.
[6] Thomas PAW,Moffatt CE,Rudd D,et al. S-100β in chronic subdural haematoma:Prospective cohort study [J]. J Clin Neurosci,2019,11(67):145-150.
[7] 刘晓刚,刘寒松,王二玲,等.颅脑外伤术后血清神经生化标志物及其脑脊液中P73、P38蛋白表达的意义[J].安徽医药,2022,26(1):76-81.
[8] 吴承远,刘玉光.临床神经外科学(第2版)(精)[M].北京:人民卫生出版社,2007:45.
[9] 刘仁群.GCS评分单的改良[J].护理学杂志,2010,25(18):7.
[10] 周小炫,谢敏,陶静,等.简易智能精神状态检查量表的研究和应用[J].中国康复医学杂志,2016,31(6):694- 696,706.
[11] Czy■-Szypenbejl K,M?誰drzycka-D?諭browska W,Kwiecień- Jagu■ K,et al. The Occurrence of Postoperative Cognitive Dysfunction (POCD)-Systematic Review [J]. Psychiatr Pol,2019,53(1):145-160.
[12] 李新琳,吴艳飞,王丽丽,等.麻醉恢复室患者全麻苏醒期躁动的影响因素及与术后认知功能障碍的关系研究[J].现代生物医学进展,2021,21(16):3074-3078
[13] 付小菊,刘军,狄玉涵,等.血糖变异性与颅脑损伤患者术后认知功能障碍的关系研究[J].实用心脑肺血管病杂志,2021,29(7):74-79.
[14] Safavynia SA,Goldstein PA. The Role of Neuroinflammation in Postoperative Cognitive Dysfunction:Moving From Hypothesis to Treatment [J]. Front Psychiatry,2019,17(9):752.
[15] Charmsaz S,Hughes ?魪,Bane FT,et al. S100β as a serum marker in endocrine resistant breast cancer [J]. BMC Med,2017,15(1):79.
[16] 刘高虹,兰青,张湾,等.西格列汀对高糖诱导的肾小管上皮细胞凋亡和p38丝裂原活化蛋白激酶通路的影响[J].中华糖尿病杂志,2019,11(4):282-286.
[17] 司艳芳,周历,赵娟,等.阿司匹林通过激活p38丝裂原活化蛋白激酶损伤视网膜色素上皮细胞的屏障功能[J].中华老年心脑血管病杂志,2020,22(8):858-861.
[18] 康文越,邢丹丹,付强,等.右美托咪定通过p38通路改善发育期大鼠七氟醚麻醉后认知功能障碍[J].中国免疫学杂志,2020,36(9):1091-1096.
[19] 张小军,段海真,华维,等.复方脑肽节苷脂治疗急性颅脑损伤的临床研究和对血清神经元再生因子的影响[J].中国临床药理学杂志,2020,36(5):493-495,502.
[20] Zhang J,Nie Y,Pang Q,et al. Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage:a randomised control trial [J]. BMC Anesthesiol,2021,21(1):23.
[21] Zhang X,Green MV,Thayer SA. HIV gp120-induced neuroinflammation potentiates NMDA receptors to overcome basal suppression of inhibitory synapses by p38 MAPK [J]. J Neurochem,2019,148(4):499-515.
[22] 冯辉,藏莉,张德重.通窍活血汤对外伤后水瘀互结型脑积水患者血清神经生化标志物及脑脊液p73,p38蛋白表达的影响[J].中国实验方剂学杂志,2017,23(13):185-190.
[23] 宋永福,何升学,赵金兵,等.高血压性基底节区脑出血患者血清S100钙结合蛋白B、神经特异性烯醇化酶水平对病情的评估及预后的预测价值[J].临床神经病学杂志,2020,33(1):17-22.
[24] Castagna C,Merighi A,Lossi L. Decreased Expression of Synaptophysin 1 (SYP1 Major Synaptic Vesicle Protein p38) and Contactin 6 (CNTN6/NB3) in the Cerebellar Vermis of reln Haplodeficient Mice [J]. Cell Mol Neurobiol,2019,39(6):833-856.
[25] 林玫君,区铭乾,孙芙蓉,等.S100B蛋白在中枢神经系统疾病中的临床意义及研究进展[J].海南医学,2020, 31(6):767-771.